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General NPI Number Information
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NPI Number | 1508105842
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Entity Type | Organization
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Legal Business Name | STEPHEN R. HOLUK MD INC
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Dates
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Enumeration Date | 02/06/2013
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 2175 MAIN ST.
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City | THREE RIVERS
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State | MA
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Zip | 01080
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Country | US
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Telephone | 413-283-7171
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Fax | 413-283-7171
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Provider Business Mailing Address
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Address Line | 2175 MAIN ST.
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City | THREE RIVERS
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State | MA
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Zip | 01080
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Country | US
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Telephone | 413-283-7171
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Fax | 413-283-8809
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN R HOLUK
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Credential | M.D.
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Telephone | 413-283-7171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 48798
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License Number State | MA
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