Individual
JASON OMAR HOLCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2070 BIDDLE AVE, SUITE 200, WYANDOTTE, MI 48192-4080
(734) 225-9100
(734) 225-9100
Mailing address
30055 NORTHWESTERN HWY STE L-30, FARMINGTON HILLS, MI 48334-3211
(248) 865-4238
(248) 865-4237
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301080364
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28427
BLUE CROSS
MI
01
—
1699102244
GROUP NPI HENRY FORD WYANDOTTE
—
Enumeration date
03/29/2007
Last updated
06/27/2019
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