Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 10464 | WV |
NPI | 1093166076 |
---|---|
Provider Name | Dr. Bradley Henry Hoffman |
First Address | Charleston, WV 25314-1063 |
Second Address | Princeton, WV 24740-3636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2016 |
Last Update Date | 15/06/2020 |