Provider Demographics
NPI:1205006897
Name:HOFFMAN, DANIEL MORSE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MORSE
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2010
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58122-2484
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1213 15TH AVE W STE 102
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-3800
Practice Address - Country:US
Practice Address - Phone:701-234-8860
Practice Address - Fax:701-234-8924
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170293207N00000X
WI55291-20207N00000X
CODR.0058256207N00000X
ND15286207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1205006897Medicaid
WIHOFFMDANOtherMERCYCARE INSURANCE
WIP00973665DB7792OtherRR MEDICARE
IL$$$$$$$$$ 1Medicaid
WI541760809Medicare PIN