Individual
DR. BRENT P HOLMQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10109 MAPLE ST, OMAHA, NE 68134-5554
(402) 572-3500
(402) 572-3505
Mailing address
PO BOX 642117, OMAHA, NE 68164-8117
(402) 398-6255
(402) 829-8513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25252
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098684135
MEDICARE PTAN
NE
Enumeration date
04/10/2008
Last updated
06/11/2014
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