Provider Demographics
NPI:1225078033
Name:SHOFF, FRED IRVIN II (DO)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:IRVIN
Last Name:SHOFF
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51719 STATE ROUTE 26
Mailing Address - Street 2:
Mailing Address - City:JERUSALEM
Mailing Address - State:OH
Mailing Address - Zip Code:43747-9728
Mailing Address - Country:US
Mailing Address - Phone:740-926-1156
Mailing Address - Fax:
Practice Address - Street 1:103A PLAZA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9773
Practice Address - Country:US
Practice Address - Phone:740-695-9321
Practice Address - Fax:740-695-6212
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003936207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine