Provider Demographics
NPI:1780660266
Name:KRANICH, HOLGER (MD)
Entity Type:Individual
Prefix:DR
First Name:HOLGER
Middle Name:
Last Name:KRANICH
Suffix:
Gender:M
Credentials:MD
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 N 75TH AVE
Mailing Address - Street 2:CIGNA MEDICAL GROUP, WESTRIDGE CENTER
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-1216
Mailing Address - Country:US
Mailing Address - Phone:623-849-7500
Mailing Address - Fax:623-849-7785
Practice Address - Street 1:2302 N 75TH AVE
Practice Address - Street 2:CIGNA MEDICAL GROUP, WESTRIDGE CENTER
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-1216
Practice Address - Country:US
Practice Address - Phone:623-849-7500
Practice Address - Fax:623-849-7785
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2010-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ30898207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH91776Medicare UPIN