Provider Demographics
NPI:1881724532
Name:HOLT, STEVEN PAUL (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:HOLT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2600 LAKE LUCIEN DR STE 180
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7235
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-875-0518
Practice Address - Street 1:4890 CASCADE ROAD, SUITE 130
Practice Address - Street 2:
Practice Address - City:GAND RAPIDS
Practice Address - State:MA
Practice Address - Zip Code:49546
Practice Address - Country:US
Practice Address - Phone:616-975-2795
Practice Address - Fax:616-975-2797
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301046317208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB49078Medicare UPIN