Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 25MA06000800 | NJ |
N | 204F00000X | Transplant Surgeon | MD056219L | PA |
N | 208200000X | Surgeon | 25MA06000800 | NJ |
N | 208600000X | Surgeon | 25MA06000800 | NJ |
NPI | 1275596629 |
---|---|
Provider Name | Dr. Michael J Holman |
First Address | Princeton, NJ 08540-3611 |
Second Address | Princeton, NJ 08540-3611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 07/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D38224 | (02) | PA |