Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 5703 | WI |
N | 207YP0228X | Pediatric Otolaryngology | 12256615-1205 | UT |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 12256615-1205 | UT |
NPI | 1992106355 |
---|---|
Provider Name | Matthew R. Hoffman |
First Address | Salt Lake City, UT 84132-0001 |
Second Address | Salt Lake City, UT 84132-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2014 |
Last Update Date | 04/11/2021 |