Individual
MARK IRVIN HOLUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1406 6TH AVE N, ST CLOUD, MN 56303
(320) 251-2700
(320) 656-7026
Mailing address
1406 6TH AVE N, ST CLOUD, MN 56303
(320) 251-2700
(320) 656-7026
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33545
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
826305100
—
MN
Enumeration date
05/11/2006
Last updated
12/21/2012
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