Provider Demographics
NPI:1275600041
Name:STEVEN B. HOLSTEN, MD, PC
Entity Type:Organization
Organization Name:STEVEN B. HOLSTEN, MD, PC
Other - Org Name:HOLSTEN, WAGNER & SOMMER ORTHOPEDIC SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOLSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-734-3476
Mailing Address - Street 1:PO BOX 9135
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-9135
Mailing Address - Country:US
Mailing Address - Phone:603-893-9784
Mailing Address - Fax:603-893-8886
Practice Address - Street 1:299 CAREW ST
Practice Address - Street 2:SUITE 409
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2301
Practice Address - Country:US
Practice Address - Phone:413-734-3476
Practice Address - Fax:413-734-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM13454OtherBLUE CROSS B LUE SHIELD
MAM13454Medicare PIN