Individual
DR. SUSAN M HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6425 NICOLLET AVE, SUITE 202, RICHFIELD, MN 55423-1668
(612) 869-2086
(612) 869-4903
Mailing address
8170 33RD AVE S, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
30007
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0316269
MEDICA
MN
01
—
100189
U CARE
MN
05
—
137592000
—
MN
01
—
492003
PREFERRED ONE
MN
01
—
49637HO
BLUE CROSS BLUE SHIELD
MN
01
—
HP13424
HEALTH PARTNERS
MN
Enumeration date
09/02/2006
Last updated
03/12/2021
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