Healthcare Provider Details

I. General information

NPI: 1265844906
Provider Name (Legal Business Name): MC HOSPITALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2014
Last Update Date: 05/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 W KING ST
OWOSSO MI
48867-2120
US

IV. Provider business mailing address

PO BOX 638558
CINCINNATI OH
45263-8558
US

V. Phone/Fax

Practice location:
  • Phone: 989-723-5211
  • Fax: 989-725-7902
Mailing address:
  • Phone: 800-424-3672
  • Fax: 954-377-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN G. HOLTZCLAW
Title or Position: PRESIDENT
Credential: MD
Phone: 800-424-3672