Individual
MAURA JANE HOLCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1618 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Mailing address
1618 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
70591
MT
207N00000X
Dermatology Physician
Primary
M16146
ID
207R00000X
Internal Medicine Physician
BP10044142
TX
Other
Enumeration date
05/08/2012
Last updated
12/03/2021
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