Individual
DR. MARK HOFSTETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1224 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-6582
(706) 922-0191
(706) 922-0192
Mailing address
1224 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-6582
(706) 922-0191
(706) 922-0192
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
067643
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003123605A
—
GA
01
—
52590314
BCBS OF GA
GA
05
—
GA1300
—
SC
Enumeration date
07/18/2005
Last updated
01/21/2014
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