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NPI Code Detail

MEDICARE: DAVID ROBERT HOLLIE MD

MEDICARE: DAVID ROBERT HOLLIE 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1598609307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID ROBERT HOLLIE MD
Provider Business Mailing Address
First Line : 501 S CHIPETA WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1222
Country : US
Telephone Number : 801-581-7951
Fax Number :
Provider Business Practice Location Address
First Line : 501 S CHIPETA WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1222
Country : US
Telephone Number : 801-581-7951
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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