MEDICARE: DR. DAVID BRANNON HOLT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101034316	VA

General Provider Information

NPI Number	:	1508805888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID BRANNON HOLT M.D.

Provider Business Mailing Address
First Line	:	4660 HAYGOOD RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-5436
Country	:	US
Telephone Number	:	757-460-0243
Fax Number	:	757-460-1011

Provider Business Practice Location Address
First Line	:	4660 HAYGOOD RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-5436
Country	:	US
Telephone Number	:	757-460-0243
Fax Number	:	757-460-1011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	01/17/2013

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