Healthcare Provider Details

I. General information

NPI: 1447982327
Provider Name (Legal Business Name): SAMUEL ELLIOTT HOLBERT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 SCHOENERSVILLE RD
BETHLEHEM PA
18017-7300
US

IV. Provider business mailing address

2545 SCHOENERSVILLE RD DEPARTMENT OF EMERGENCY MEDICINE, 5TH FLOOR SOUTH BLD
BETHLEHEM PA
18017-7300
US

V. Phone/Fax

Practice location:
  • Phone: 484-884-2521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOT022961
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberLL87676
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: