Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD22064 | ME |
NPI | 1013995760 |
---|---|
Provider Name | Dr. Darryl Hoffman |
First Address | Brewer, ME 04412-1006 |
Second Address | Bangor, ME 04401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 24/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01628591 | (05) | NY |
F65225 | (02) |