Provider Demographics
NPI:1972581445
Name:HOFFER, DEBORAH R (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:R
Last Name:HOFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:ROGELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DH - PEDIATRICS
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-653-9663
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DH - PEDIATRICS
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-653-9663
Practice Address - Fax:603-650-0910
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160132208000000X
NH15920208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1202092OtherUNITED HEALTHCARE
MA5131736OtherAETNA
MA160132OtherTUFTS
MA202028OtherHARVARD PILGRIM
MAB10368502OtherCIGNA
MAJ21187OtherBLUE CROSS
MA0018581OtherNEIGHBORHOOD HEALTH
MA3197719Medicaid
MAB10368502OtherCIGNA
H08424Medicare UPIN