Individual
DR. CLINTON DOUGLAS HOLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4604 29TH ST E, PALMETTO, FL 34221-9793
(941) 845-4572
(941) 845-4572
Mailing address
4604 29TH ST E, PALMETTO, FL 34221-9793
(941) 845-4572
(941) 845-4572
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
40558
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042203700
—
FL
01
—
30588
BLUE CROSS/BLUE SHIELD
FL
01
—
440003237
RAILROAD MEDICARE
FL
01
—
5600211
GHI
FL
01
—
9205221
UNITEDHEALTHCARE
FL
01
—
923014
BLUE CROSS/BLUE SHIELD
PA
01
—
ME0040558
WORKERS' COMPENSATION
FL
Enumeration date
07/01/2005
Last updated
03/07/2023
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