Individual
MICHAEL D HOFTIEZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 WOODLAND DR, MANITOWOC, WI 54220-9662
(920) 320-6212
(920) 684-5548
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28153
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100003091
WEA
WI
01
—
110079278
RAILROAD MEDICARE
WI
01
—
20016
NETWORK HEALTH PLAN
WI
01
—
28153
TOUCHPOINT
WI
05
—
30838500
—
WI
01
—
390806395002
CHAMPUS
WI
01
—
B53651
CIGNA
WI
Enumeration date
08/29/2006
Last updated
01/31/2012
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