Provider Demographics
NPI:1124220256
Name:SYLVIA K HOLLOWELL M D P L L C
Entity Type:Organization
Organization Name:SYLVIA K HOLLOWELL M D P L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:KRISTINE
Authorized Official - Last Name:HOLLOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-559-5640
Mailing Address - Street 1:20905 GREENFIELD RD STE 507
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5351
Mailing Address - Country:US
Mailing Address - Phone:248-559-5640
Mailing Address - Fax:
Practice Address - Street 1:20905 GREENFIELD RD STE 507
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5351
Practice Address - Country:US
Practice Address - Phone:248-559-5640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION23300Medicare ID - Type Unspecified
MIH01746Medicare UPIN