Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 297754 | NY |
Y | 208200000X | Surgeon | 297754 | NY |
Y | 208600000X | Surgeon | 297754 | NY |
NPI | 1285605402 |
---|---|
Provider Name | David R Holt |
First Address | Rochester, NY 14617-5504 |
Second Address | Rochester, NY 14621-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 24/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
203979059 | MEDICARE PTAN (01) | IL |