Provider Demographics
NPI:1598775660
Name:HOLMES, GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:
Last Name:HOLMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:201 CEDAR SE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106
Mailing Address - Country:US
Mailing Address - Phone:505-848-3700
Mailing Address - Fax:505-848-3703
Practice Address - Street 1:201 CEDAR SE
Practice Address - Street 2:SUITE 700
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:505-848-3700
Practice Address - Fax:505-848-3703
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM942682080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM17958Medicaid
NM17958Medicaid
E49357Medicare UPIN