Basic Information
Provider Information
NPI: 1730197617
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOFT
FirstName: DANIEL
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3691 RUTGER AVE
Address2: PROVIDER ENROLLMENT
City: ST LOUIS
State: MO
PostalCode: 63110
CountryCode: US
TelephoneNumber: 3149774440
FaxNumber:  
Practice Location
Address1: 3660 VISTA
Address2:  
City: ST LOUIS
State: MO
PostalCode: 63110
CountryCode: US
TelephoneNumber: 3145778648
FaxNumber: 3147713816
Other Information
ProviderEnumerationDate: 08/04/2006
LastUpdateDate: 03/17/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X102043MOY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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