Provider Demographics
NPI:1407874647
Name:HOLDING, MICHELE Y (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:Y
Last Name:HOLDING
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:PO BOX 222
Mailing Address - Street 2:THE BACK PAIN CENTER PC
Mailing Address - City:SPRING CITY
Mailing Address - State:PA
Mailing Address - Zip Code:19475
Mailing Address - Country:US
Mailing Address - Phone:610-495-8416
Mailing Address - Fax:866-427-9472
Practice Address - Street 1:100 1ST AVE
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460
Practice Address - Country:US
Practice Address - Phone:610-495-8416
Practice Address - Fax:866-427-9472
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-12-04
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2008-06-19
Provider Licenses
StateLicense IDTaxonomies
PAMD051973L2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA510594TJCMedicare PIN
PAG04483Medicare UPIN