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NPI Code Detail

MEDICARE: HOSPITALIST SERVICES MEDICAL GROUP OF HAMILTON, INC.

MEDICARE: HOSPITALIST SERVICES MEDICAL GROUP OF HAMILTON, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician1429528OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DB6528OTHEROHGROUP RRMEDICARE NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3203436OTHEROHEEOICP GRP PROVIDER #

General Provider Information

NPI Number : 1730174087
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOSPITALIST SERVICES MEDICAL GROUP OF HAMILTON, INC.
Provider Business Mailing Address
First Line : 4750 HEMPSTEAD STATION DR
Second Line :
City : KETTERING
State : OH
Zip : 45429-5164
Country : US
Telephone Number : 800-875-0136
Fax Number : 937-619-4231
Provider Business Practice Location Address
First Line : 630 EATON AVE
Second Line :
City : HAMILTON
State : OH
Zip : 45013-2767
Country : US
Telephone Number : 513-867-2000
Fax Number :
Authorized Official
Title or Position : COO
Name : PAUL W KOLODZIK
Credential : MD
Telephone Number : 800-726-3627
Provider Enumeration Date : 09/13/2005
Last Update Date : 04/20/2008

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