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General NPI Number Information
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NPI Number | 1558499467
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Entity Type | Individual
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Provider Name | LORI GREEN STOTZ MD
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 6054 S STATE ROUTE 48
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City | MAINEVILLE
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State | OH
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Zip | 45039-8280
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Country | US
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Telephone | 513-981-5760
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Fax | 513-981-5769
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Provider Business Mailing Address
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Address Line | 6054 S STATE ROUTE 48
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City | MAINEVILLE
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State | OH
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Zip | 45039-8280
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Country | US
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Telephone | 513-981-5760
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Fax | 513-981-5769
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OH 35078232
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License Number State | OH
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