| Mark Irvin Holub, MD | |
|
1406 6th Ave N, St Cloud, MN 56303 | |
| (320) 251-2700 | |
| (320) 656-7026 |
| Full Name | Mark Irvin Holub |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1406 6th Ave N, St Cloud, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720038714 | NPI | - | NPPES |
| 826305100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 33545 (Minnesota) | Primary |
| Entity Name | Regents Of The University Of Minnesota |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114019858 PECOS PAC ID: 7416856059 Enrollment ID: O20040102000679 |
| Entity Name | St Cloud Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043269798 PECOS PAC ID: 4880594779 Enrollment ID: O20110221000134 |
| Entity Name | Centracare Health System-nr Llc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1275872772 PECOS PAC ID: 3870739410 Enrollment ID: O20130426000215 |
| Entity Name | Centracare Health System-nr Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558600874 PECOS PAC ID: 3870739410 Enrollment ID: O20130515000683 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Irvin Holub, MD 1406 6th Ave N, St Cloud, MN 56303 Ph: (320) 251-2700 | Mark Irvin Holub, MD 1406 6th Ave N, St Cloud, MN 56303 Ph: (320) 251-2700 |
Theresa Marie Mccabe Lau, MD Psychiatry & Neurology Medicare: May Accept Medicare Assignments Practice Location: 1900 Centra Care Cir, Ste 1325, St Cloud, MN 56303 Phone: 320-255-5796 Fax: 320-229-5179 | |
Troy A Payne, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1200 Sixth Ave N, Centra Care Clinic, St Cloud, MN 56303 Phone: 320-251-0726 Fax: 302-229-5188 | |
John Preston Daniels, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1406 6th Avenue North, St Cloud Hospital, St Cloud, MN 56303 Phone: 320-251-2700 Fax: 320-229-5109 | |
Kathleen A. Rieke, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1200 Sixth Ave No, Centracare Clinic, St Cloud, MN 56303 Phone: 320-252-5131 | |
Mary Elizabeth Lunde, DO Psychiatry & Neurology Medicare: May Accept Medicare Assignments Practice Location: 1406 6th Avenue North, St Cloud Hospital, St Cloud, MN 56303 Phone: 320-251-2700 Fax: 320-656-7115 | |
Mr. Roger P Handrich, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1321 13th St N, St Cloud, MN 56303 Phone: 320-252-5010 Fax: 320-203-1855 | |
James C Romanowsky, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1200 Sixth Ave No, Centracare Clinic, St Cloud, MN 56303 Phone: 320-252-5131 |