Provider Demographics
NPI:1811900541
Name:HOLTER SCANNING PC
Entity type:Organization
Organization Name:HOLTER SCANNING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-626-0766
Mailing Address - Street 1:2405 E 14 MILE RD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5961
Mailing Address - Country:US
Mailing Address - Phone:586-264-6079
Mailing Address - Fax:586-264-2039
Practice Address - Street 1:2405 E 14 MILE RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5961
Practice Address - Country:US
Practice Address - Phone:586-264-6079
Practice Address - Fax:586-264-2039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDA5164OtherRAILROAD MEDICARE
MI1063490894OtherNPI GOLDSTEIN
MI1346212800OtherNPI BORIN
MI0N584500Medicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER N