Provider Demographics
NPI:1588724454
Name:HOLLOWAY, FRANK B (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:B
Last Name:HOLLOWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2799 W GRAND BLVD
Mailing Address - Street 2:UROLOGY DEPT - K9
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2608
Mailing Address - Country:US
Mailing Address - Phone:313-916-2062
Mailing Address - Fax:313-916-1462
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:UROLOGY DEPT - K9
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-2062
Practice Address - Fax:313-916-1462
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI051838208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FH051838OtherCHAMPUS-CHAMPUS
FH051838OtherCOMMERCIAL-COMMERCIAL NUMBER
MI284766310Medicaid
340H264460OtherBLUE CROSS-BLUE CROSS
FH051838OtherCHAMPUS-CHAMPUS
FH051838OtherCOMMERCIAL-COMMERCIAL NUMBER