Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 0101258624 | VA |
N | 207X00000X | Orthopaedic Surgeon | C10007584 | DE |
N | 207X00000X | Orthopaedic Surgeon | MA07484000 | NJ |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MA07484000 | NJ |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MD419362 | PA |
NPI | 1144371824 |
---|---|
Provider Name | Candice P. Holden |
First Address | Baltimore, MD 21275-5868 |
Second Address | Reston, VA 22031-3219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 02/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001908218(PA) | (05) | NJ |
0019082180006 | (05) | PA |
1000015353 | (05) | DE |
406194200 | (05) | MD |
8905207 | (05) | NJ |
H68913 | (02) |