Provider Demographics
NPI:1538187927
Name:HOFFMAN, PATRICIA S (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:S
Other - Last Name:HALLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 67000
Mailing Address - Street 2:DEPARTMENT 272801
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-0002
Mailing Address - Country:US
Mailing Address - Phone:517-841-6913
Mailing Address - Fax:517-841-6917
Practice Address - Street 1:400 HINCKLEY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-6125
Practice Address - Country:US
Practice Address - Phone:517-784-0588
Practice Address - Fax:517-784-3866
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052854207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8362111OtherCIGNA HEALTHCARE
MI105187038Medicaid
MIP00411808OtherRR MEDICARE
MI080087194OtherRAILROAD MEDICARE