Provider Demographics
NPI:1215908561
Name:HOFFMAN, CATHERINE ANN (MD)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:640 SUMMIT CROSSING PL
Mailing Address - Street 2:STE 204
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2142
Mailing Address - Country:US
Mailing Address - Phone:704-865-0626
Mailing Address - Fax:704-865-6531
Practice Address - Street 1:640 SUMMIT CROSSING PL
Practice Address - Street 2:STE 204
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2142
Practice Address - Country:US
Practice Address - Phone:704-865-0626
Practice Address - Fax:704-865-6531
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800908207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911655Medicaid
NC8911655Medicaid
NC2259428BMedicare PIN