MEDICARE: STEPHEN J. HOENIG, MD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician		MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M17242	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1578561569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN J. HOENIG, MD, PC

Provider Business Mailing Address
First Line	:	340 MAIN STREET
Second Line	:	SUITE 670
City	:	WORCESTER
State	:	MA
Zip	:	01608-1681
Country	:	US
Telephone Number	:	508-754-3566
Fax Number	:	508-798-8012

Provider Business Practice Location Address
First Line	:	50 MEMORIAL DR
Second Line	:	SUITE 112
City	:	LEOMINSTER
State	:	MA
Zip	:	01453-2238
Country	:	US
Telephone Number	:	978-534-3399
Fax Number	:	978-537-4929

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHEN J HOENIG
Credential	:	M.D.
Telephone Number	:	978-534-3399

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	07/21/2022

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