Provider Demographics
NPI:1982699286
Name:STOLTZ, MICHELLE C (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:C
Last Name:STOLTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 S POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5411
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:970-356-2264
Practice Address - Street 1:1501 S POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5411
Practice Address - Country:US
Practice Address - Phone:303-625-6432
Practice Address - Fax:970-356-2264
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40726207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO840592369-07OtherPACIFICARE
CO00154873Medicaid
COST660150OtherBCBS
CO10522065OtherCAQH ID
CO840592369007OtherROCKY MTN HEALTH
CO10522065OtherCAQH ID
CO160059685Medicare ID - Type UnspecifiedMEDICARE RAILROAD
COST660150OtherBCBS
COH70199Medicare UPIN