Provider Demographics
NPI:1194798785
Name:HOFMANN, LEWIS
Entity type:Individual
Prefix:
First Name:LEWIS
Middle Name:
Last Name:HOFMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2427 KEMPER RD
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:WHITE HOUSE MEDICAL UNIT
Practice Address - Street 2:THE WHITE HOUSE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20502-0001
Practice Address - Country:US
Practice Address - Phone:202-757-2476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-043-647-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine