Organization
HOLZUM HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DEBOLD (ACCT MANAGER)
(314) 432-2580
Entity
Organization
Contact information
Practice address
2 PROGRESS POINT, STE 101A, O FALLON, MO 63368-2208
(636) 236-9945
Mailing address
PO BOX 1125, MARYLAND HEIGHTS, MO 63043-0125
(314) 432-2580
(314) 432-0223
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
110686
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO2172
RAILROAD MEDICARE
MO
Enumeration date
10/28/2008
Last updated
11/25/2009
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