Provider Demographics
NPI:1710063987
Name:HOFFMAN, DAVID A (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:A
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1220 BELMONT AVENUE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504
Mailing Address - Country:US
Mailing Address - Phone:330-743-3644
Mailing Address - Fax:330-743-2737
Practice Address - Street 1:1220 BELMONT AVENUE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504
Practice Address - Country:US
Practice Address - Phone:330-743-3644
Practice Address - Fax:330-743-2737
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002486207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0407545Medicaid
HO0462822Medicare ID - Type Unspecified
OH9916451Medicare PIN
OH0407545Medicaid
OH060000740Medicare PIN