Provider Demographics
NPI:1306111950
Name:STEVEN A HOLPER MD PC
Entity type:Organization
Organization Name:STEVEN A HOLPER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-878-3510
Mailing Address - Street 1:3233 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1938
Mailing Address - Country:US
Mailing Address - Phone:702-878-3510
Mailing Address - Fax:702-878-1405
Practice Address - Street 1:3233 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1938
Practice Address - Country:US
Practice Address - Phone:702-878-3510
Practice Address - Fax:702-878-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6061261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV33211Medicare PIN
NVC43163Medicare UPIN