Individual
WILTON RUSSELL HOLMAN III
Active
Individual
WILTON RUSSELL HOLMAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20544
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000055398
—
AL
05
—
009941749
—
AL
05
—
105489
—
AL
05
—
122606
—
AL
05
—
169815
—
AL
01
—
300113603
RRMC
AL
01
—
510-55398
BLUE CROSS
AL
01
—
511-09727
BLUE CROSS
AL
01
—
511-56374
BLUE CROSS
AL
01
—
515-39411
BLUE CROSS
AL
01
—
515-94523
BLUE CROSS
AL
01
—
7575354
AETNA
AL
Enumeration date
06/15/2005
Last updated
12/30/2015
Update your record
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