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General NPI Number Information
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NPI Number | 1558387324
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Entity Type | Individual
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Provider Name | STEPHEN TIMOTHY HOLLAND MD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 50 GAYLORD FARM RD
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City | WALLINGFORD
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State | CT
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Zip | 06492-2899
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Country | US
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Telephone | 203-284-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 15 BEACH AVE
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City | WATERTOWN
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State | CT
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Zip | 06795-2001
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Country | US
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Telephone | 203-741-3302
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 027428
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 027428
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License Number State | CT
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