Provider Demographics
NPI:1730612086
Name:HOLLIS, MARIDITH (MD)
Entity type:Individual
Prefix:DR
First Name:MARIDITH
Middle Name:
Last Name:HOLLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 A AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5036
Mailing Address - Country:US
Mailing Address - Phone:319-369-7211
Mailing Address - Fax:
Practice Address - Street 1:7400 ROPER LN
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-5274
Practice Address - Country:US
Practice Address - Phone:251-378-6500
Practice Address - Fax:251-378-6563
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-488422084P0800X
390200000X
AL376892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program