Provider Demographics
NPI:1699955039
Name:STOLTZ, STEVEN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:STOLTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:555 E 5TH ST APT 821
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3959
Mailing Address - Country:US
Mailing Address - Phone:888-648-3390
Mailing Address - Fax:888-648-3390
Practice Address - Street 1:555 E 5TH ST APT 821
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3959
Practice Address - Country:US
Practice Address - Phone:888-648-3390
Practice Address - Fax:888-648-3390
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2019-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN62763207Q00000X
TXM8364207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CY729OtherBCBS
TX206124403Medicaid
TXTXB138830Medicare PIN