Provider Demographics
NPI:1982602975
Name:HOENIG, STEPHEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:HOENIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4792
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4792
Mailing Address - Country:US
Mailing Address - Phone:978-534-3399
Mailing Address - Fax:978-537-4929
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:SUITE 112
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-534-3399
Practice Address - Fax:978-537-4929
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA813642086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA315G011Medicaid
MAA21071Medicare ID - Type Unspecified
G24129Medicare UPIN