Individual
ALVIN C HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 495-6200
(952) 883-9677
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30351
MN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
30351
MN
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
30351
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
995787100
—
MN
Enumeration date
08/18/2006
Last updated
09/01/2023
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