Mitchell Stotland, MD is a medicare enrolled "Preventive Medicine - Occupational Medicine" physician in Grandville, Michigan. His current practice location is
2885 Sanford Ave Sw, Unit 46566, Grandville, Michigan. You can reach out to his office (for appointments etc.) via phone at
(616) 730-1838.
Mitchell Stotland is licensed to practice in California (license number A165176) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1245612969.
Physician's Profile
| Full Name | Mitchell Stotland |
|---|
| Gender | Male |
|---|
| Speciality | Preventive Medicine - Occupational Medicine |
|---|
| Location | 2885 Sanford Ave Sw, Grandville, Michigan |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1245612969
- Provider Enumeration Date: 06/19/2015
- Last Update Date: 07/29/2024
Medicare PECOS Information:
- PECOS PAC ID: 7012252083
- Enrollment ID: I20181219001437
Medical Identifiers
Medical identifiers for Mitchell Stotland such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245612969 | NPI | - | NPPES |
| 150879 | Other | AK | STATE LICENSE |
| 25MA10667900 | Other | NJ | STATE LICENSE |
| 281631 | Other | MA | STATE LICENSE |
| 32094 | Other | NE | STATE LICENSE |
| 35.136962CTR | Other | OH | STATE LICENSE |
| 71877-20 | Other | WI | STATE LICENSE |
| MD048607 | Other | DC | STATE LICENSE |
| MD23245 | Other | ME | STATE LICENSE |
| 0101267722 | Other | VA | STATE LICENSE |
| 01078523A | Other | IN | LICENSE |
| 20824 | Other | NV | STATE LICENSE |
| 4301500489 | Other | MI | STATE LICENSE |
| 83897 | Other | GA | GEORGIA |
| DR.0062841 | Other | CO | STATE LICENSE |
| M-14856 | Other | ID | STATE LICENSE |
| 12446A | Other | WY | STATE LICENSE |
| 27184 | Other | MS | STATE LICENSE |
| 300527 | Other | NY | STATE LICENSE |
| 16110 | Other | ND | STATE LICENSE |
| 19979 | Other | NH | STATE LICENSE |
| 320861 | Other | LA | STATE LICENSE |
| 35092 | Other | OK | STATE LICENSE |
| 59945 | Other | TN | STATE LICENSE |
| 66243 | Other | MN | STATE LICENSE |
| MED-PHYS-LIC87942 | Other | MT | STATE LICENSE |
| 036150640 | Other | IL | STATE LICENSE |
| 04-42551 | Other | KS | STATE LICENSE |
| MD-46545 | Other | IA | STATE LICENSE |
| MD195637 | Other | OR | STATE LICENSE |
| MD60972416 | Other | WA | STATE LICENSE |
| S3935 | Other | TX | STATE LICENSE |
| C1-0013395 | Other | DE | STATE LICENSE |
| MD2019-0869 | Other | NM | STATE LICENSE |
| 042.0014551 | Other | VT | STATE LICENSE |
| 2019024778 | Other | MO | STATE LICENSE |
| 252874 | Other | NC | NC |
| 28795 | Other | WV | STATE LICENSE |
| A165176 | Other | CA | STATE LICENSE |
| E-12568 | Other | AR | STATE LICENSE |
| MD20739 | Other | HI | STATE LICENSE |
| ME141497 | Other | FL | FLORIDA |
| 11351098-1205 | Other | UT | STATE LICENSE |
| 12115 | Other | SD | STATE LICENSE |
| 38550 | Other | AL | LICENSE |
| 53070 | Other | KY | STATE LICENSE |
| 59141 | Other | AZ | LICENSE |
| 82992 | Other | SC | STATE LICENSE |
| D0088242 | Other | MD | STATE LICENSE |
| MD16846 | Other | RI | STATE LICENSE |
| MD468233 | Other | PA | STATE LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2083X0100X | Preventive Medicine - Occupational Medicine | MD468233 (Pennsylvania) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | D0088242 (Maryland) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 83897 (Georgia) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 35.136962CTR (Ohio) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 0101267722 (Virginia) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 4301500489 (Michigan) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 59141 (Arizona) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 38550 (Alabama) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | E-12568 (Arkansas) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 150879 (Alaska) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 53070 (Kentucky) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 01078523A (Indiana) | Secondary |
| 208D00000X | General Practice | 28795 (West Virginia) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | A165176 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mitchell Stotland is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mitchell Stotland, MD
2885 Sanford Ave Sw Ste 46566,
Grandville, MI 49418-1342
Ph: () - | Mitchell Stotland, MD
2885 Sanford Ave Sw, Unit 46566,
Grandville, MI 49418-1342
Ph: (616) 730-1838 |
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