Provider Demographics
NPI:1861545386
Name:SAHLHOFF, RICHARD L (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:SAHLHOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6110 HOLTON RD
Mailing Address - Street 2:PO BOX 69
Mailing Address - City:TWIN LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49457-8528
Mailing Address - Country:US
Mailing Address - Phone:231-828-6848
Mailing Address - Fax:231-828-4763
Practice Address - Street 1:6110 HOLTON RD
Practice Address - Street 2:
Practice Address - City:TWIN LAKE
Practice Address - State:MI
Practice Address - Zip Code:49457-8528
Practice Address - Country:US
Practice Address - Phone:231-828-6848
Practice Address - Fax:231-828-4763
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006248207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE26680Medicare UPIN
MIT1856132731012Medicare ID - Type Unspecified