Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | OS008334L | PA |
Y | 208600000X | Surgeon | OS008334L | PA |
NPI | 1013903285 |
---|---|
Provider Name | David Randall Hofius |
First Address | New Castle, PA 16101-2271 |
Second Address | New Castle, PA 16101-2271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014943080009 | (05) | PA |
F06581 | (02) | PA |