Provider Demographics
NPI:1598728891
Name:HOLT, PETER DAVID (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:DAVID
Last Name:HOLT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11995 SINGLETREE LN
Mailing Address - Street 2:STE 500
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5347
Mailing Address - Country:US
Mailing Address - Phone:952-595-1301
Mailing Address - Fax:612-294-4903
Practice Address - Street 1:1200 QUEEN EMMA ST
Practice Address - Street 2:APT 1511
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-6300
Practice Address - Country:US
Practice Address - Phone:952-595-1100
Practice Address - Fax:612-294-4903
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2015-06-23
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Provider Licenses
StateLicense IDTaxonomies
IDM92222085R0202X
HIMD-162972085R0202X
VT042-00109012085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology