Provider Demographics
NPI:1841418894
Name:HOLDER, KEVIN NEIL (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:NEIL
Last Name:HOLDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:500 LILLY RD NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5195
Mailing Address - Country:US
Mailing Address - Phone:360-413-8525
Mailing Address - Fax:360-413-8800
Practice Address - Street 1:7720 US HIGHWAY 98 W STE 110
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-7231
Practice Address - Country:US
Practice Address - Phone:850-267-1603
Practice Address - Fax:850-622-3342
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2022-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME134420207RC0000X
WAMD 60217395207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease