Provider Demographics
NPI:1386648012
Name:HOLMQUIST, HUGH RALPH (MD)
Entity Type:Individual
Prefix:
First Name:HUGH
Middle Name:RALPH
Last Name:HOLMQUIST
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:PO BOX 906
Mailing Address - Street 2:
Mailing Address - City:BURWELL
Mailing Address - State:NE
Mailing Address - Zip Code:68823-0906
Mailing Address - Country:US
Mailing Address - Phone:308-346-5544
Mailing Address - Fax:308-346-4744
Practice Address - Street 1:410 SOUTH 8TH AVE
Practice Address - Street 2:
Practice Address - City:BURWELL
Practice Address - State:NE
Practice Address - Zip Code:68823
Practice Address - Country:US
Practice Address - Phone:308-346-5544
Practice Address - Fax:308-346-4744
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19518207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47083890800Medicaid
NE35194OtherBLUE CROSS BLUE SHIELD
NE47083890826Medicaid
NE47083890820Medicaid
NE47083890820Medicaid
NEF60236Medicare UPIN
NE47083890800Medicaid