Provider Demographics
NPI:1316985021
Name:HOFFMAN, JULIA SEROV (MD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:SEROV
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:MN
Mailing Address - Zip Code:56267-1312
Mailing Address - Country:US
Mailing Address - Phone:320-589-4008
Mailing Address - Fax:
Practice Address - Street 1:400 EAST FIRST STREET
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:MN
Practice Address - Zip Code:56267
Practice Address - Country:US
Practice Address - Phone:320-589-1313
Practice Address - Fax:320-589-3533
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN42192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN660197900Medicaid