Individual
MARK HOLBREICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
01035981
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000076229
ANTHEM
IN
05
—
100327390
—
IN
Enumeration date
02/22/2006
Last updated
11/25/2009
Update your record
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