Organization
HIGHLAND HOSPITALIST SERVICES MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL W KOLODZIK MD (CEO)
(800) 875-0136
Entity
Organization
Contact information
Practice address
1275 N HIGH ST, HILLSBORO, OH 45133-8273
(937) 393-6100
(937) 393-6333
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1572198
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2639621
—
OH
01
—
DE3424
RR MEDICARE
—
Enumeration date
06/12/2006
Last updated
10/15/2007
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