Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD011904E | PA |
NPI | 1043364334 |
---|---|
Provider Name | Dr. Eric K. Holm |
First Address | Reading, PA 19611-1427 |
Second Address | Reading, PA 19611-1427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 04/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000179429 | HIGHMARK (01) | PA |
0007588780001 | (05) | PA |
03019601 | CAPITAL BLUE CROSS (01) | PA |
E55510 | (02) | PA |