Provider Demographics
NPI:1053303727
Name:HOLLAND, CHRISTOPHER MATTHEW (DPM)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:HOLLAND
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 E RAYMOND ST STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-4783
Mailing Address - Country:US
Mailing Address - Phone:317-957-2000
Mailing Address - Fax:
Practice Address - Street 1:3403 E RAYMOND ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-4783
Practice Address - Country:US
Practice Address - Phone:317-957-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY234213E00000X, 213ES0103X
KY00234213E00000X
IN07001439A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90013897OtherKYHEALTH CHOICES-DME
KY480026332OtherRAILROAD MEDICARE
IN300092538Medicaid
KY1115102OtherPASSPORT
KY1221960002OtherPALMETTO GBA-DMERC
KY80002348Medicaid
KY000000067936OtherBCBS
KY90013897OtherKYHEALTH CHOICES-DME