Individual
MARK E HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2090 WOODWINDS DR, SUITE 307, WOODBURY, MN 55125-2522
(651) 968-5801
(651) 968-5899
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
(651) 968-5042
(651) 968-5904
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
31292
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200018337
RAILROAD MEDICARE
MN
05
—
680787900
—
MN
Enumeration date
03/14/2006
Last updated
06/25/2015
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