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Individual

MICHAEL R HOLT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777
Mailing address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
01042309
IN
2085N0700X
Neuroradiology Physician
01042309
IN
2085N0904X
Nuclear Radiology Physician
01042309
IN
2085P0229X
Pediatric Radiology Physician
01042309
IN
2085R0202X
Diagnostic Radiology Physician
01042309
IN
2085R0202X
Diagnostic Radiology Physician
Primary
30411
WI
2085R0203X
Therapeutic Radiology Physician
01042309
IN
2085R0204X
Vascular & Interventional Radiology Physician
01042309
IN
2085U0001X
Diagnostic Ultrasound Physician
01042309
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100364900
IN
Enumeration date
09/12/2005
Last updated
11/10/2014
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