Individual
DR. STEPHEN P HOLLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2405 W LEXINGTON AVE, ELKHART, IN 46514-1417
(574) 295-8805
(574) 522-0039
Mailing address
2405 W LEXINGTON AVE, ELKHART, IN 46514-1417
(574) 295-8805
(574) 522-0039
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
01028966
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082176
ANTHEM BLUE CROSS
IN
05
—
100326840
—
IN
01
—
15835
PHYSICIANS HEALTH PLAN
IN
Enumeration date
06/27/2006
Last updated
07/09/2007
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