MITCHELL STOTLAND (NPI# 1245612969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245612969 |
| Entity Type | Individual |
| Full Name | MITCHELL STOTLAND |
| Credential | M.D. |
| Practice Address |
2885 Sanford Ave Sw Unit 46566 Grandville MI 49418-1342 |
| Mailing Address |
2885 Sanford Ave Sw Ste 46566 Grandville MI 49418-1342 |
| Practice Telephone | 6167301838 |
| Practice Fax Number | 8009889999 |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2020-06-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
01078523A | IN | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 28795 | WV | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | LICENSE | 38550 | 01 |
| FL | FLORIDA | ME141497 | 01 |
| GA | GEORGIA | 83897 | 01 |
| NC | NC | 252874 | 01 |
| AZ | LICENSE | 59141 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Medical Center Dr, Morgantown, WV 265061200 | 6167301838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497775456 | Mitchell Andrew Stotland | Plastic Surgery | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-07-20 |
| Street Address |
2885 SANFORD AVE SW UNIT 46566 |
| City | GRANDVILLE |
| State | MI |
| Zip Code | 49418-1342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710953666 | Vijil K Rahulan | Family Medicine | 2885 Sanford Ave Sw, Suite No. 18083, Grandville, MI 49418-1342 | 2006-02-28 |
| 1487199436 | Organic Relief Massage Services | Physical Therapist | 2885 Sanford Ave Sw, Pmb 23774, Grandville, MI 49418-1342 | 2016-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144799669 | Holly Cieslinski | Occupational Therapist | 3550 Fairlines Ave, Grandville, MI 49418 | 2018-11-14 |
| 1639664857 | Athletico Ltd | Physical Therapist | 3819 Rivertown Pkwy Sw Ste 100, Grandville, MI 49418 | 2018-06-29 |
| 1437651916 | Great Lakes Wellness Counseling LLC | Counselor | 2900 Wilson Ave Suite 110, Grandville, MI 49418 | 2018-03-01 |
| 1780111765 | Jenna Sargent | Nurse Practitioner | 2845 44th St Sw, Ste 200, Grandville, MI 49418 | 2017-05-22 |
| 1881132827 | Laura Elizabeth Ramaker | Specialist/Technologist | 2787 Pine Dunes Ct Sw, Wyoming, MI 49418 | 2017-02-10 |
| 1689026130 | Charles Unseld | Hearing Instrument Specialist | O-38 44th St Sw, Grandville, MI 49418 | 2016-07-08 |
| 1972989655 | Laci Dawn Johncock | Physical Therapy Assistant | 2786 56th Street, Wyoming, MI 49418 | 2015-08-05 |
| 1891178570 | Joshua Kolman | Pharmacist | 3434 Century Center Dr Sw, Grandville, MI 49418 | 2015-06-30 |
| 1710368782 | Tracie Medrano- Smith | Family Medicine | 4174 56th St Sw, Wyoming, MI 49418 | 2015-06-15 |
| 1124410808 | Kim Michelle Childress | Counselor | 4565 Wilson Ave Sw Ste 3a, Grandville, MI 49418 | 2015-03-04 |
| Find all providers in zip 49418 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871750505 | Natural Health Improvement Center PC | General Practice | 4466 Heritage Ct Sw, Suite D, Grandville, MI 49418-2383 | 2008-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326649120 | Source Medical Solutions Pllc | General Practice | 625 Kenmoor Ave Se Ste 301, Grand Rapids, MI 49546-2395 | 2020-11-06 |
| 1043832801 | Ksk Medical Pllc | General Practice | 6300 Winter Rd, Manitou Beach, MI 49253-9634 | 2020-05-14 |
| 1275184921 | Home Physicians Group Inc | General Practice | 18481 W 10 Mile Rd Ste 102, Southfield, MI 48075-2621 | 2019-09-24 |
| 1558913251 | Baybrooke Counseling | General Practice | 421 St. Josephs Ave, Suttons Bay, MI 49682 | 2019-07-12 |
| 1962062539 | Healthcare Alliance Pllc | General Practice | 35 S Johnson St Ste 1b, Pontiac, MI 48341-1660 | 2019-06-17 |
| 1356905061 | Comprehensive Care Medical Services | General Practice | 1747 Andover Ln Se, East Grand Rapids, MI 49506-4805 | 2019-04-29 |
| 1336602812 | Mk Certified, LLC | General Practice | 2140 Stone Rd, Ann Arbor, MI 48105-2535 | 2019-04-10 |
| 1215422555 | The Natural Momma Me Initiative | General Practice | 11000 W Mcnichols Rd Ste 212, Detroit, MI 48221-2389 | 2018-06-28 |
| 1881183028 | Silverstone Medical Group, Pllc | General Practice | 805 Oakwood Dr Ste 111, Rochester, MI 48307-1359 | 2018-05-03 |
| 1245739903 | Breanna Lee Brookens | General Practice | 1531 Barnard St, Saginaw, MI 48602-4902 | 2018-02-08 |
| Find all providers with the same taxonomy | ||||
| City | GRANDVILLE |
| Zip Code | 49418 |
Please comment or provide details below to improve the information on MITCHELL STOTLAND.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.