Organization
HOLT FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK M RICHARDSON M.D. (PRESIDENT)
(517) 694-1466
Entity
Organization
Contact information
Practice address
4378 HOLT RD, HOLT, MI 48842-1666
(517) 694-1466
(517) 694-5142
Mailing address
4378 HOLT RD, HOLT, MI 48842-1666
(517) 694-1466
(517) 694-5142
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080C364770
BCBS GROUP ID
MI
Enumeration date
08/17/2006
Last updated
03/26/2008
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