Provider Demographics
NPI:1356449227
Name:LINDHOLM, PATRICIA J (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:LINDHOLM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 SOUTH CASCADE STREET
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2813
Mailing Address - Country:US
Mailing Address - Phone:218-736-8000
Mailing Address - Fax:218-739-6742
Practice Address - Street 1:712 SOUTH CASCADE STREET
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2813
Practice Address - Country:US
Practice Address - Phone:218-736-8000
Practice Address - Fax:218-739-6742
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33575207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01-00795OtherMEDICA
NE41091744413Medicaid
MNHP26727OtherHEALTHPARTNERS
MN27675LIOtherBLUECROSSBLUESHIELD
MN015003700Medicaid
ND12087Medicaid
MN1008792OtherPREFERREDONE
MN110128OtherUCARE
MN01-00795OtherMEDICA
MN110128OtherUCARE
MN089004583Medicare ID - Type UnspecifiedMEDICAREWRC
MN015003700Medicaid