Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 0101051268 | VA |
NPI | 1023072907 |
---|---|
Provider Name | Dr. Michael Anthony Holliday |
First Address | Alexandria, VA 22304 |
Second Address | Alexandria, VA 22304-1535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6703119 | (05) | VA |