Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | D0056525 | MD |
NPI | 1003085093 |
---|---|
Provider Name | Andrew E. Holzman |
First Address | Mc Lean, VA 22102-3388 |
Second Address | Mc Lean, VA 22102-4227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2008 |
Last Update Date | 12/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F08207 | (02) |