Active NPI
Mitchell Andrew Stotland, MD
- Plastic Surgery Physician
- Lebanon, NH
National Provider Identifier
1497775456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 10106
- Practice address
- 1 Medical Center Dr
Lebanon, NH 03756-1000 - Phone
- (603) 650-8068
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 10106 | NH | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Lebanon, NH 03756-1000
Mailing address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-8068
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30010608 | Medicaid | NH | |
| 0RE4555 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10106 | NH | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312156800000",
"number": "1497775456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-8068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-8068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOTLAND",
"first_name": "MITCHELL",
"middle_name": "ANDREW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2011-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "NH",
"license": "10106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30010608",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0RE4555",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.