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NPI Code Detail

MEDICARE: CHASE WAYNE SOFIAK D.O.

MEDICARE: CHASE WAYNE SOFIAK D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician103959GA
22085R0202XDiagnostic Radiology PhysicianOS18641FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457886046
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHASE WAYNE SOFIAK D.O.
Provider Business Mailing Address
First Line : 1111 HAYES AVE
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-3323
Country : US
Telephone Number : 419-502-2800
Fax Number : 419-502-2821
Provider Business Practice Location Address
First Line : 1673 MASON AVE STE 305
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32117-5516
Country : US
Telephone Number : 386-274-7118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2017
Last Update Date : 12/02/2025

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Directions to “ CHASE WAYNE SOFIAK D.O.” Practice Location

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