Provider Demographics
NPI:1912909995
Name:HOFFMAN, ELIZABETH A (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 MONROE ST UNIT 209
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2735
Mailing Address - Country:US
Mailing Address - Phone:419-291-6720
Mailing Address - Fax:419-291-6729
Practice Address - Street 1:5700 MONROE ST UNIT 209
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2735
Practice Address - Country:US
Practice Address - Phone:419-291-6720
Practice Address - Fax:419-291-6729
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35068322207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0162854Medicaid
OH04-02983OtherUHC
OH000000141189OtherANTHEM
OH110176019OtherRRMC
OH01992OtherPARAMOUNT
OH0662087OtherAETNA
OH0662087OtherAETNA
OHHO0783412Medicare ID - Type Unspecified