Healthcare Provider Details

I. General information

NPI: 1033195987
Provider Name (Legal Business Name): RICHARD GARETH HOLZ M.D,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 THOMAS JOHNSON DR SUITE 204
FREDERICK MD
21702-4423
US

IV. Provider business mailing address

174 THOMAS JOHNSON DR SUITE 204
FREDERICK MD
21702-4423
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-2300
  • Fax: 301-662-7364
Mailing address:
  • Phone: 301-662-2300
  • Fax: 301-662-7364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberD0015520
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: