Holles-Sobota, Staci M

Holles-Sobota, Staci M is an individual health care provider with primary practice located at 8384 Charlotte Hwy , Indian Land SC 29707-6532. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Holles-Sobota, Staci M can be contacted via phone (703) 689-9037.

Contact Information

Primary practice address
8384 Charlotte Hwy Indian Land SC 29707-6532
Phone: (703) 689-9037
Fax: (703) 689-9109
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 37739 South Carolina
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 0102202037 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 37739 South Carolina

Profile Details

NPI number 1740471077
LBN Legal business name Holles-Sobota, Staci M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2007
Last updated Sep 18th, 2019 - about 5 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 1740471077 NPPES
South Carolina MEDICAID 377391

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