Provider Demographics
NPI:1558627562
Name:SHOFFNER, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:SHOFFNER
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 1:1500 E MEDICAL CENTER DR, SPC 5033
Mailing Address - Street 2:TAUBMAN CENTER, FLOOR 2, RECEPTION C
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5033
Mailing Address - Country:US
Mailing Address - Phone:734-936-5738
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR SPC 5033
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5033
Practice Address - Country:US
Practice Address - Phone:734-936-5738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program