Provider Demographics
NPI:1497866800
Name:HOLLMAN, MARY ANN (MD, MS, CIME)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:HOLLMAN
Suffix:
Gender:F
Credentials:MD, MS, CIME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:148 MOLEHULEHU LOOP
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-4511
Mailing Address - Country:US
Mailing Address - Phone:808-205-0603
Mailing Address - Fax:808-419-6493
Practice Address - Street 1:111 HANA HWY STE 107
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2300
Practice Address - Country:US
Practice Address - Phone:808-205-0603
Practice Address - Fax:808-419-6493
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9N852083P0500X
HIMD-186682083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE86041Medicare UPIN