Healthcare Provider Details

I. General information

NPI: 1053303727
Provider Name (Legal Business Name): CHRISTOPHER MATTHEW HOLLAND DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3403 E RAYMOND ST STE A
INDIANAPOLIS IN
46203-4783
US

IV. Provider business mailing address

3403 E RAYMOND ST STE A
INDIANAPOLIS IN
46203-4783
US

V. Phone/Fax

Practice location:
  • Phone: 317-957-2070
  • Fax:
Mailing address:
  • Phone: 317-957-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number234
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00234
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number234
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number07001439A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: