Basic Information
Provider Information
NPI: 1487625141
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOFFMANN
FirstName: ROBERT
MiddleName: M.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 43 WHITING HILL RD STE 300
Address2:  
City: BREWER
State: ME
PostalCode: 044121006
CountryCode: US
TelephoneNumber: 2079735035
FaxNumber:  
Practice Location
Address1: 1 NORTHEAST DR
Address2:  
City: BANGOR
State: ME
PostalCode: 044014332
CountryCode: US
TelephoneNumber: 2072753800
FaxNumber: 2072753803
Other Information
ProviderEnumerationDate: 01/31/2006
LastUpdateDate: 01/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X008941MEY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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