Individual
DUSTIN J. HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
1701 N SENATE BLVD, ROOM DG 412, INDIANAPOLIS, IN 46202-1239
(317) 962-5975
(317) 963-5492
Mailing address
250 N SHADELAND AVENUE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(702) 577-7956
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01075400A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201233570
—
IN
Enumeration date
06/10/2014
Last updated
07/02/2015
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