Provider Demographics
NPI:1689633869
Name:HOFER, BRADLEY O (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:O
Last Name:HOFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:950 E HARVARD AVE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-7009
Mailing Address - Country:US
Mailing Address - Phone:303-778-6527
Mailing Address - Fax:303-733-1288
Practice Address - Street 1:950 E HARVARD AVE
Practice Address - Street 2:SUITE 550
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-7009
Practice Address - Country:US
Practice Address - Phone:303-778-6527
Practice Address - Fax:303-733-1288
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38581208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21659371Medicaid
CO21659371Medicaid
COCM5548Medicare PIN