Individual
MR. THEODORE R HOFSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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