Individual
ROBERT E. HOLLAND JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 S EAGLE RD, STE 1241, MERIDIAN, ID 83642-6351
(208) 288-2255
Mailing address
190 E BANNOCK ST, BOISE, ID 83712
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-5119
ID
207Q00000X
Family Medicine Physician
MD15650
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062182
—
OR
Enumeration date
07/07/2005
Last updated
09/27/2012
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