Individual
GREGORY P HOLDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 WEST LINCOLN STREET, SUITE 104, BELLEVILLE, IL 62220
(618) 235-0955
(618) 235-9203
Mailing address
301 WEST LINCOLN STREET, SUITE 104, BELLEVILLE, IL 62220
(618) 235-0955
(618) 235-9203
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036082418
IL
2085R0202X
Diagnostic Radiology Physician
R4N99
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179892
HEALTHLINK
—
05
—
36082418
—
IL
Enumeration date
05/18/2006
Last updated
10/14/2011
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