Healthcare Provider Details

I. General information

NPI: 1508986332
Provider Name (Legal Business Name): EXIGENCE HOSPITALIST MEDICAL SERVICES OF LEWISTON, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 MILITARY RD
LEWISTON NY
14092-1903
US

IV. Provider business mailing address

PO BOX 3295
BUFFALO NY
14240-3295
US

V. Phone/Fax

Practice location:
  • Phone: 716-297-4800
  • Fax: 716-692-4342
Mailing address:
  • Phone: 716-692-3302
  • Fax: 716-692-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: STEPHEN G HOLTZCLAW
Title or Position: OWNER
Credential: MD
Phone: 856-686-4317