Individual
MARK RICHARD HOFELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1815
(937) 641-3477
(937) 641-5410
Mailing address
1 CHILDRENS PLZ, DAYTON, OH 45404-1815
(937) 641-3000
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
35.053020
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000541691
ANTHEM
OH
05
—
0765024
—
OH
Enumeration date
02/09/2006
Last updated
12/30/2020
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