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Individual

MARK JOHN HOLLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2301 SAN PEDRO DR NE, SUITE B, ALBUQUERQUE, NM 87110-4119
(505) 232-6818
Mailing address
2301 SAN PEDRO DR NE, SUITE B, ALBUQUERQUE, NM 87110-4119
(505) 232-6818

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
91 65
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
91-65
NEW MEXICO MEDICAL BOARD LICENSE NUMBER
NM
Enumeration date
06/16/2008
Last updated
11/12/2012
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