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General NPI Number Information
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NPI Number | 1043227564
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Entity Type | Individual
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Provider Name | STEPHEN EDWARD HOLMES M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 40520 COUNTY HIGHWAY 34
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City | OGEMA
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State | MN
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Zip | 56569-9612
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Country | US
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Telephone | 218-983-4300
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Fax | 218-983-6217
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Provider Business Mailing Address
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Address Line | 915 TENTH AVENUE NORTH
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City | GLASGOW
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State | MT
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Zip | 59230
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Country | US
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Telephone | 406-228-4763
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11351
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD186627
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License Number State | OR
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