Provider Demographics
NPI:1447859988
Name:HOFFMAN, DEAN MATTHEW
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:MATTHEW
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18560 POLING RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-9157
Mailing Address - Country:US
Mailing Address - Phone:937-209-9115
Mailing Address - Fax:
Practice Address - Street 1:18560 POLING RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9157
Practice Address - Country:US
Practice Address - Phone:937-209-9115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-24
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker