Individual
STACI M HOLLES-SOBOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
8384 CHARLOTTE HWY, INDIAN LAND, SC 29707-6532
(703) 689-9037
(703) 689-9109
Mailing address
1300 PICCARD DRIVE, SUITE 202 EMERGENCY MEDICINE ASSOCIATES, ROCKVILLE, MD 20850-4303
(301) 921-7900
(301) 921-7915
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0102202037
VA
207P00000X
Emergency Medicine Physician
37739
SC
207Q00000X
Family Medicine Physician
Primary
37739
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377391
—
SC
Enumeration date
08/01/2007
Last updated
09/18/2019
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