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NPI Code Detail

MEDICARE: DR. MICHAEL HOLLIFIELD M.D.

MEDICARE: DR. MICHAEL HOLLIFIELD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician39065KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134191307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL HOLLIFIELD M.D.
Provider Business Mailing Address
First Line : 4710 JEFFERSON ST NE
Second Line : JENNY CEBADA
City : ALBUQUERQUE
State : NM
Zip : 87109-2155
Country : US
Telephone Number : 505-884-1114
Fax Number : 505-884-3004
Provider Business Practice Location Address
First Line : 4710 JEFFERSON ST NE
Second Line : JENNY CEBADA
City : ALBUQUERQUE
State : NM
Zip : 87109-2155
Country : US
Telephone Number : 505-884-1114
Fax Number : 505-884-3004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 02/10/2010

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