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Individual

DR. CRAIG D HOLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
496 SHOUP AVE W STE B, TWIN FALLS, ID 83301-5043
(208) 734-7676
(208) 736-8378
Mailing address
496 SHOUP AVE W STE B, TWIN FALLS, ID 83301-5043
(208) 734-7676
(208) 736-8378

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
P119
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010015646
REGENCE BLUE SHIELD OF ID
ID
05
002143900
ID
05
1093924813
ID
01
4134570001
DMERC
ID
01
480031477
RAILROAD MEDICARE
ID
01
820491190
PRIVATE INSURANCES
ID
01
P2397
BLUE CROSS OF IDAHO
ID
Enumeration date
05/21/2007
Last updated
08/03/2010
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