Basic Information
Provider Information
NPI: 1073586533
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLT
FirstName: ERIK
MiddleName:  
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 7851 S ELATI ST
Address2: SUITE 202
City: LITTLETON
State: CO
PostalCode: 801208080
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 214 E 23RD ST
Address2: UPMC SHADYSIDE HOSPITAL
City: CHEYENNE
State: WY
PostalCode: 820013748
CountryCode: US
TelephoneNumber: 3076342273
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/07/2006
LastUpdateDate: 06/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X7174AWYY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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