Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301083829 | MI |
N | 2080P0216X | Pediatric Rheumatologist | 2007014909 | MO |
Y | 2080P0216X | Pediatric Rheumatologist | 4301083829 | MI |
NPI | 1801910617 |
---|---|
Provider Name | Dr. Mark F Hoeltzel |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48108-4259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 31/07/2013 |