Provider Demographics
NPI:1043206089
Name:HOLCOMB, SHEILA RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:RAE
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 LINCOLN ST NE
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3314
Mailing Address - Country:US
Mailing Address - Phone:712-546-3630
Mailing Address - Fax:712-546-3634
Practice Address - Street 1:714 LINCOLN ST NE
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3314
Practice Address - Country:US
Practice Address - Phone:712-546-3630
Practice Address - Fax:712-546-3634
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA31355207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA6130872Medicaid
IA080128541OtherRAILROAD MEDICARE
IA45074OtherWELLMARK BC/BS
IA45074OtherWELLMARK BC/BS