Healthcare Provider Details

I. General information

NPI: 1801330287
Provider Name (Legal Business Name): IPC HOSPITALISTS OF NEW ENGLAND PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 WORCESTER ST SUITE 3
SPRINGFIELD MA
01151-1045
US

IV. Provider business mailing address

819 WORCESTER ST SUITE 3
SPRINGFIELD MA
01151-1045
US

V. Phone/Fax

Practice location:
  • Phone: 413-543-6820
  • Fax:
Mailing address:
  • Phone: 413-543-6820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN HOLTZCLAW
Title or Position: PRESIDENT AND CEO
Credential: MD
Phone: 965-693-1000