MEDICARE: DR. JEFFREY B STOWITTS DO

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
1	207Q00000X	Family Medicine Physician	5101012632	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CA8440	OTHER	MI	RAILRAOD MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1770559320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY B STOWITTS DO

Provider Business Mailing Address
First Line	:	406 EAST ELM STREET
Second Line	:	PO BOX 730
City	:	CARSON CITY
State	:	MI
Zip	:	48811
Country	:	US
Telephone Number	:	989-584-3131
Fax Number	:	989-584-6734

Provider Business Practice Location Address
First Line	:	1014 EAST WASHINGTON
Second Line	:
City	:	GREENVILLE
State	:	MI
Zip	:	48838
Country	:	US
Telephone Number	:	616-754-7145
Fax Number	:	616-754-7110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	04/20/2011

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