MEDICARE: DR. CHRISTOPHER MATTHEW HOLLAND DPM

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	213E00000X	Podiatrist	234	KY
2	213E00000X	Podiatrist	00234	KY
3	213ES0103X	Foot & Ankle Surgery Podiatrist	234	KY
4	213E00000X	Podiatrist	07001439A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	480026332	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	90013897	OTHER	KY	KYHEALTH CHOICES-DME
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1115102	OTHER	KY	PASSPORT
5	1221960002	OTHER	KY	PALMETTO GBA-DMERC
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	000000067936	OTHER	KY	BCBS

General Provider Information

NPI Number	:	1053303727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER MATTHEW HOLLAND DPM

Provider Business Mailing Address
First Line	:	3403 E RAYMOND ST STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-4783
Country	:	US
Telephone Number	:	317-957-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3403 E RAYMOND ST STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-4783
Country	:	US
Telephone Number	:	317-957-2070
Fax Number	:

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	03/04/2025

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Directions to “ DR. CHRISTOPHER MATTHEW HOLLAND DPM” Practice Location

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