Doctor Name: | ERIC P HOLMGREN |
NPI Number: | 1619083565 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 227532 |
Business Practice Address: | Oral And Facial Surgery Associates 77 Hospital Drive North Adams, MA - 01247 |
Business Phone Number: | 4136644100 |
Business Fax Number: | |
Mailing Address: | 77 Hospital Ave, Ste 212 NORTH ADAMS |
State: | MA |
Postal Code: | 012472538 |
Phone Number: | 4136644100 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2006 |
NPI Last Update Date: | 06/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204E00000X |
License Number: | 227532 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Oral & Maxillofacial Surgery |
Taxonomy Specialization: | |
Taxonomy Definition: |