Provider Demographics
NPI:1275686735
Name:RICHARD L. SAHLHOFF, DO
Entity Type:Organization
Organization Name:RICHARD L. SAHLHOFF, DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-672-3032
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006248207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT191066858Medicaid
MIE26680Medicare UPIN
MIT1856132731012Medicare ID - Type Unspecified