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Individual

DR. CHARLES REED HOLT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2026 N MAIN ST, DAVENPORT, IA 52803-2911
(515) 537-0326
Mailing address
2026 N MAIN ST, DAVENPORT, IA 52803-2911
(515) 537-0326

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02981
IA
207P00000X
Emergency Medicine Physician
4350
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1477638005
BLUE SHIELD
IA
05
1477638005
IA
05
6131490
IA
Enumeration date
10/25/2006
Last updated
08/14/2009
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