Physician Compare National (NPI:1902837800)

HEALTHCARE PROVIDER: MICHAEL G STIFF M.D., INC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1902837800
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597945212
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110211000445
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STIFF
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	GERARD
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1982
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	615 COPELAND MILL RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1E
	Group Practice or individual's line 2 address
City	WESTERVILLE
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	430818904
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MOUNT CARMEL ST ANN'S
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360035
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MOUNT CARMEL WEST
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	360006
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	RIVERSIDE METHODIST HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y