Healthcare Provider Details

I. General information

NPI: 1063785541
Provider Name (Legal Business Name): MARC J HOLZMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW SUITE 416
WASHINGTON DC
20006-1003
US

IV. Provider business mailing address

2021 K ST NW SUITE 416
WASHINGTON DC
20006-1003
US

V. Phone/Fax

Practice location:
  • Phone: 202-296-1333
  • Fax: 202-296-9357
Mailing address:
  • Phone: 202-296-1333
  • Fax: 202-296-9357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberMD14106
License Number StateDC

VIII. Authorized Official

Name: MARC J HOLZMAN
Title or Position: PHYSICIAN
Credential:
Phone: 202-296-1333