Healthcare Provider Details

I. General information

NPI: 1811976871
Provider Name (Legal Business Name): THOMAS FRANCIS HOLOVACS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST SUITE 3G
BOSTON MA
02114-2621
US

IV. Provider business mailing address

55 FRUIT ST SUITE 3G
BOSTON MA
02114-2621
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-0298
  • Fax: 617-726-0620
Mailing address:
  • Phone: 617-726-0298
  • Fax: 617-726-0620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number209815
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: