Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME112681 | FL |
NPI | 1083833990 |
---|---|
Provider Name | Dr. Adam Matthias Holdt |
First Address | Pensacola, FL 32514-6050 |
Second Address | Pensacola, FL 32514-6050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 21/06/2012 |