Provider Demographics
NPI:1811004617
Name:BRITZ, JOSEPH L (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
Last Name:BRITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 N ATKINSON DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-1953
Mailing Address - Country:US
Mailing Address - Phone:231-843-3487
Mailing Address - Fax:231-843-1962
Practice Address - Street 1:7 N ATKINSON DR
Practice Address - Street 2:SUITE 111
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-1953
Practice Address - Country:US
Practice Address - Phone:231-843-3487
Practice Address - Fax:231-843-1962
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060161174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3026682Medicaid
MIF75426Medicare UPIN
MI3026682Medicaid