Provider Demographics
NPI:1255334116
Name:HULSEBERG, KEVIN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:WILLIAM
Last Name:HULSEBERG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2 HOSPITAL DR
Mailing Address - Street 2:STE 201
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-6614
Mailing Address - Country:US
Mailing Address - Phone:413-536-8670
Mailing Address - Fax:413-534-0597
Practice Address - Street 1:2 HOSPITAL DR
Practice Address - Street 2:STE 201
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6614
Practice Address - Country:US
Practice Address - Phone:413-536-8670
Practice Address - Fax:413-534-0597
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2011-03-31
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Provider Licenses
StateLicense IDTaxonomies
MA150499207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology