1376494955 NPI number — DR. ELAD YAACOV HOLZER M.D.

Table of content: DR. ELAD YAACOV HOLZER M.D. (NPI 1376494955)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376494955 NPI number — DR. ELAD YAACOV HOLZER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLZER
Provider First Name:
ELAD
Provider Middle Name:
YAACOV
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376494955
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
607-180 ROSLYN ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINNIPEG
Provider Business Mailing Address State Name:
MANITOBA
Provider Business Mailing Address Postal Code:
R3L 0S7
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
671 WILLIAM AVE.
Provider Second Line Business Practice Location Address:
AE107D
Provider Business Practice Location Address City Name:
WINNIPEG
Provider Business Practice Location Address State Name:
MANITOBA
Provider Business Practice Location Address Postal Code:
R3E 0Z2
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)