Provider Demographics
NPI:1861484750
Name:HOITINK, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:HOITINK
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 1:311 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1818
Mailing Address - Country:US
Mailing Address - Phone:803-366-7175
Mailing Address - Fax:803-366-0529
Practice Address - Street 1:311 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1818
Practice Address - Country:US
Practice Address - Phone:803-366-7175
Practice Address - Fax:803-366-0529
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD20161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC201613Medicaid
SCG53639Medicare UPIN