Provider Demographics
NPI:1801455233
Name:HOLMBERG, DAVID VINING (PA-C)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:VINING
Last Name:HOLMBERG
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Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:12631 E 17TH AVENUE,
Mailing Address - Street 2:MAIL STOP B202
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045
Mailing Address - Country:US
Mailing Address - Phone:720-848-1900
Mailing Address - Fax:
Practice Address - Street 1:1635 AURORA CT FL 4
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-848-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2021-06-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant