Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | D0029586 | MD |
Y | 207W00000X | Ophthalmologist | MD14016 | DC |
NPI | 1033206586 |
---|---|
Provider Name | Dr. Marc Jay Holzman |
First Address | Washington, DC 20006-1003 |
Second Address | Washington, DC 20006-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 05/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10420614 | CAQH (01) | DC |
B392-0001 | BLUE CROSS BLUE SHIELD (01) | DC |
C61476 | (02) | DC |