MITCHELL STOTLAND M.D. NPI 1245612969

NPI Information

NPI: 1245612969
Provider Name: MITCHELL STOTLAND, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2885 SANFORD AVE SW
UNIT 46566
GRANDVILLE, MI
ZIP 49418
Phone: (616) 730-1838
Get Directions

Mitchell Stotland, M.D. is a general practice in Grandville, MI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Mitchell Stotland, M.D. NPI is 1245612969. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2885 SANFORD AVE SW
UNIT 46566
GRANDVILLE, MI
ZIP 49418-342
Phone: (616) 730-1838
Fax: (800) 988-9999

The NPI 1245612969 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/19/2015 and was last updated on 6/25/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2083X0100X	Preventive Medicine	Occupational Medicine	01078523A	INDIANA	No
2	390200000X	Student in an Organized Health Care Education/Training Program				No
3	208D00000X	General Practice		28795	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	38550	OTHER	ALABAMA	LICENSE
2	ME141497	OTHER	FLORIDA	FLORIDA
3	83897	OTHER	GEORGIA	GEORGIA
4	252874	OTHER	NORTH CAROLINA	NC
5	59141	OTHER	ARIZONA	LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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