Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 01056115A | IN |
NPI | 1043218357 |
---|---|
Provider Name | Bryan D Hoff |
First Address | Bloomington, IN 47402-1329 |
Second Address | Bloomington, IN 47403-4752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 15/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200418160 | (05) | IN |
H71959 | (02) |