Basic Information
| Provider Information | |||||||||
| NPI: | 1356301311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOFIUS | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7580 AUBURN ROAD | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | CONCORD TWP | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440779406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403520400 | ||||||||
| FaxNumber: | 4403524535 | ||||||||
| Practice Location | |||||||||
| Address1: | 7580 AUBURN ROAD | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | CONCORD TWP | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440779406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403520400 | ||||||||
| FaxNumber: | 4403524535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 02/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 02/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 34-006279 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000339407 | 01 | OH | ANTHEM | OTHER | 80507 | 01 | OH | QUALCHOICE | OTHER | 160462707 | 01 | OH | TRICARE | OTHER | 6600162 | 01 | OH | UNITED HEALTHCARE | OTHER | 2051578 | 05 | OH | MEDICAID | 264200000 | 01 | OH | DEPT OF LABOR | OTHER | 264200000 | 01 | OH | FEDERAL BLACK LUNG | OTHER |