Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 25MA04914000 | NJ |
NPI | 1316168602 |
---|---|
Provider Name | Dr. William Holder |
First Address | Parsippany, NJ 07054-2252 |
Second Address | Parsippany, NJ 07054-2252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
512853 | (02) | NJ |