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Individual

MICHAEL D HOLDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
BROARDWAY AT 11TH STREET, QUINCY, IL 62350-7005
(217) 223-8400
Mailing address
2065 N. STATE HWY, NAUVOO, IL 62354-2472
(208) 866-7169

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036118552
IL
207Q00000X
Family Medicine Physician
M6837
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010001024
REGENCE BLUE SHIELD OF ID
ID
05
003729600
ID
01
72942
BLUE CROSS OF ID
ID
Enumeration date
06/21/2005
Last updated
11/07/2013
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