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Individual

MICHAEL L STOLTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
950 W MAGNOLIA AVE, FORT WORTH, TX 76104
(817) 336-5060
(817) 336-1744
Mailing address
950 W MAGNOLIA AVE, FORT WORTH, TX 76104
(817) 336-5060
(817) 336-1744

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
E1766
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10013403
AMERIGROUP
01
1646440
UNISYS MEDICAID
LA
01
4036178
AETNA
01
834763
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/20/2006
Last updated
07/08/2007
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