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Individual

GRANT K HOLLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4403 HARRISON BLVD, SUITE 3400, OGDEN, UT 84403-3271
(801) 387-3400
(801) 387-3420
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-3400
(801) 387-3420

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
165831-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107006006103
SELECTHEALTH
UT
05
204985513001
UT
01
20498551384403A002
TRIWEST
UT
01
204985513GKH
EMIA
UT
01
21114
DMBA
UT
01
25-00066
UNITED HEALTH CARE
UT
01
611697900
USDOL
UT
01
90219
PEHP
UT
01
DUUX3
BC OF IDAHO
ID
05
P00339377
ID
05
PRA01702
UT
01
QM0000006789
ALTIUS
UT
Enumeration date
09/14/2005
Last updated
03/04/2011
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