Provider Demographics
NPI:1235435223
Name:MICHAEL G STIFF MD INC
Entity type:Organization
Organization Name:MICHAEL G STIFF MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:STIFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-898-8576
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-0374
Mailing Address - Country:US
Mailing Address - Phone:614-879-0434
Mailing Address - Fax:614-879-0435
Practice Address - Street 1:495 COOPER RD
Practice Address - Street 2:SUITE 330
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8710
Practice Address - Country:US
Practice Address - Phone:614-898-8576
Practice Address - Fax:614-898-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35048596174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty