Basic Information
| Provider Information | |||||||||
| NPI: | 1689946451 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOFFHEIMER | ||||||||
| FirstName: | MARCIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11885 E 12 MILE RD | ||||||||
| Address2: | STE 300A | ||||||||
| City: | WARREN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480933474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5865826630 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11885 E 12 MILE RD | ||||||||
| Address2: | STE 300A | ||||||||
| City: | WARREN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480933474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5865826630 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2012 | ||||||||
| LastUpdateDate: | 09/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 5101019960 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | 15437 | ND | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 11415 | SD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | DO212205 | OR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | DO212205 | OR | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 5101019960 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.