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Individual

DR. GARY P HOLLOWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
46 W SHADBOLT ST, LAKE ORION, MI 48362-3170
(248) 814-9300
(248) 814-9304
Mailing address
50 N PERRY ST, PONTIAC, MI 48342-2217
(248) 338-5516
(248) 338-5547

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101012531
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3402566-11
MI
Enumeration date
07/22/2006
Last updated
07/08/2007
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