Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD072161L | PA |
NPI | 1215907084 |
---|---|
Provider Name | Dr. David O Holtz |
First Address | Wynnewood, PA 19096-3450 |
Second Address | Wynnewood, PA 19096-3450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 01/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I26576 | (02) |