MEDICARE: DR. KEVIN WESTRAY HOLCOMBE MD

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	ME112246	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659377141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN WESTRAY HOLCOMBE MD

Provider Business Mailing Address
First Line	:	3768 SUNWARD DR
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-8051
Country	:	US
Telephone Number	:	864-238-5448
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 36TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-4862
Country	:	US
Telephone Number	:	772-567-4311
Fax Number	:

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	11/24/2024

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