MEDICARE: DR. ROBERT J HOLMES MD

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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	4301042946	MI
2	208600000X	Surgery Physician	4301042946	MI

Other Identifiers

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

General Provider Information

NPI Number	:	1245210723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT J HOLMES MD

Provider Business Mailing Address
First Line	:	401 S. BALLENGER HWY
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48532-3638
Country	:	US
Telephone Number	:	810-342-1000
Fax Number	:	810-342-1591

Provider Business Practice Location Address
First Line	:	3175 W. PROFESSIONAL BLVD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-2823
Country	:	US
Telephone Number	:	989-894-3278
Fax Number	:	989-891-8155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	04/25/2012

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