Provider Demographics
NPI:1437129517
Name:HOLSTEIN, ERIC D (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:D
Last Name:HOLSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 RESEARCH PL
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2412
Mailing Address - Country:US
Mailing Address - Phone:978-454-0706
Mailing Address - Fax:978-970-0454
Practice Address - Street 1:14 RESEARCH PL
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2412
Practice Address - Country:US
Practice Address - Phone:978-454-0706
Practice Address - Fax:978-970-0454
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA72552207X00000X
NH12032207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009525Medicaid
MA3119092Medicaid
NHRE7414Medicare ID - Type Unspecified
MAJ09764Medicare ID - Type Unspecified
E47981Medicare UPIN