Provider Demographics
NPI:1033177134
Name:HOLDHUSEN, CHRISTOPHER J (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:HOLDHUSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 CREEKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-8198
Mailing Address - Country:US
Mailing Address - Phone:406-253-8151
Mailing Address - Fax:
Practice Address - Street 1:310 SUNNYVIEW LN
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3129
Practice Address - Country:US
Practice Address - Phone:406-752-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7946207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTCI2709OtherRAILROAD MEDICARE GRP ID#
MT7946OtherMONTANA STATE LICENSE
MT000008287OtherMEDICARE PART B GRP ID#
MT0040919Medicaid
MT000097881OtherBLUE CORSS/SHIELD PIN
MT080177906OtherRAILROAD MEDICARE PIN#
MT0040919Medicaid
MT000008287OtherMEDICARE PART B GRP ID#
F04163Medicare UPIN