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Individual

THERESA K HOFFMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
10215 AUBURN PARK DR, FORT WAYNE, IN 46825-2387
(260) 234-5400
(260) 234-5110
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02001618A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000091879
BLUE CROSS BLUE SHIELD
05
100332830
IN
01
P00978940
RAILROAD MEDICARE
IN
Enumeration date
11/07/2005
Last updated
01/09/2025
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