Individual
MR. THEODORE R HOFSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9250 N 3RD ST, SUITE 4030, PHOENIX, AZ 85020-2412
(602) 944-2271
(602) 943-3420
Mailing address
9250 N 3RD ST, SUITE 4030, PHOENIX, AZ 85020-2412
(602) 944-2271
(602) 943-3420
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23010
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZWCHQH
MEDICARE PTAN
—
Enumeration date
09/28/2006
Last updated
05/26/2009
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