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Individual

MARY K HOLM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6960
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0701528
MEDICA #
ND
01
0701529
MEDICA #
ND
01
0702336
MEDICA #
ND
01
12465
NDBS #
ND
01
13809
SIOUX VALLEY #
ND
01
142015
UCARE #
ND
01
17944
NDBS #
ND
05
18142
ND
05
587814400
ND
01
67D25HO
MNBS #
ND
01
6T548HO
MNBS #
ND
01
DDA9011015539
PREFERRED ONE #
ND
01
HP19491
HEALTHPARTNERS #
ND
01
ND200022
LHS #
ND
Enumeration date
07/03/2006
Last updated
10/26/2020
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