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1902898729

NPI Code Detail

MEDICARE: DR. SANDRA K HOLLOWAY MD

MEDICARE: DR. SANDRA K HOLLOWAY 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	207R00000X	Internal Medicine Physician	MD26430	OR
2	207RG0100X	Gastroenterology Physician	0101043770	VA
3	207RG0100X	Gastroenterology Physician	MD26430	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00422280	OTHER	OR	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1902898729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA K HOLLOWAY MD

Provider Business Mailing Address
First Line	:	1247 NE MEDICAL CENTER DR
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-3786
Country	:	US
Telephone Number	:	541-322-5753
Fax Number	:	541-278-8377

Provider Business Practice Location Address
First Line	:	2200 NE NEFF RD STE 302
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-4279
Country	:	US
Telephone Number	:	541-706-4220
Fax Number	:	541-597-5819

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	08/01/2024

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Directions to “ DR. SANDRA K HOLLOWAY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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