Individual
MR. HENRY MERCER HOLSOMBACK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
302 UNIVERSITY PKWY, AIKEN REGIONAL MEDICAL CENTER, AIKEN, SC 29801-6302
(803) 641-5489
(803) 641-5148
Mailing address
PO BOX 40, SULLIVANS ISLAND, SC 29482-0040
(843) 883-5830
(843) 883-5829
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26114
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0053
—
SC
Enumeration date
10/03/2005
Last updated
12/20/2007
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