Hollaway, Stacey

Hollaway, Stacey is an individual health care provider with primary practice located at 4810 Munson St Nw , Canton OH 44718-3613. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Hollaway, Stacey can be contacted via phone (330) 499-3377.

Contact Information

Primary practice address
4810 Munson St Nw Canton OH 44718-3613
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35-062821H Ohio
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35-062821H Ohio

Profile Details

NPI number 1922064906
LBN Legal business name Hollaway, Stacey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Aug 21st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922064906 NPPES
Ohio MEDICAID 0888615

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