Individual
BYRON C HOLTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11269 JEFFERSON HWY N, CHAMPLIN, MN 55316-3123
(763) 236-0600
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24071
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
508200500
—
MN
Enumeration date
04/25/2006
Last updated
05/19/2021
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