Provider Demographics
NPI:1114989035
Name:HOLM, HOLLY STEMEN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:STEMEN
Last Name:HOLM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 GRAND RIVER RD.
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116
Mailing Address - Country:US
Mailing Address - Phone:810-229-3363
Mailing Address - Fax:810-229-5532
Practice Address - Street 1:10201 GRAND RIVER RD.
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116
Practice Address - Country:US
Practice Address - Phone:810-229-3363
Practice Address - Fax:810-229-5532
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHH055985207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F79566Medicare UPIN
ON34390Medicare PIN