Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 16682 | SC |
NPI | 1003071564 |
---|---|
Provider Name | Melisa Marian Holmes |
First Address | Greenville, SC 29615-4545 |
Second Address | Greenville, SC 29605-4253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 12/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TL6954 | (05) | SC |