Healthcare Provider Details

I. General information

NPI: 1881856144
Provider Name (Legal Business Name): STEVEN DAVID HOLLOSI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MORRIS ST.
CHARLESTON WV
25301
US

IV. Provider business mailing address

1802 LOUDEN HEIGHTS RD.
CHARLESTON WV
25314
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-7170
  • Fax: 304-388-1858
Mailing address:
  • Phone: 304-388-7170
  • Fax: 304-388-1858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2419
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2014-020703
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: