MEDICARE: HOLLY SPRINGS PEDIATRICS

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	208000000X	Pediatrics Physician	200601114	NC

General Provider Information

NPI Number	:	1558514752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLLY SPRINGS PEDIATRICS

Provider Business Mailing Address
First Line	:	106 HYANNIS DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-8327
Country	:	US
Telephone Number	:	919-249-4700
Fax Number	:	919-249-4701

Provider Business Practice Location Address
First Line	:	106 HYANNIS DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-8327
Country	:	US
Telephone Number	:	919-249-4700
Fax Number	:	919-249-4701

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MS. STACEY LYNN SWARTZ-SMITH
Credential	:
Telephone Number	:	919-249-4700

Provider Enumeration Date	:	10/31/2008
Last Update Date	:	02/07/2011

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Practice Location Address:

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27540-8327

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1467896134 — NAZIR AHMAD DDS II PA
Practice Location Address:

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Directions to “HOLLY SPRINGS PEDIATRICS ” Practice Location

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