Provider Demographics
NPI:1861491656
Name:HOLLAND, EDWARD I (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:I
Last Name:HOLLAND
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1520 S DOBSON RD
Mailing Address - Street 2:SUITE 210A
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4725
Mailing Address - Country:US
Mailing Address - Phone:480-464-8600
Mailing Address - Fax:480-464-8600
Practice Address - Street 1:1520 S DOBSON RD
Practice Address - Street 2:SUITE 210A
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4725
Practice Address - Country:US
Practice Address - Phone:480-464-8600
Practice Address - Fax:480-464-7744
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ294502080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ610768OtherALSECS
C66015Medicare UPIN