Healthcare Provider Details

I. General information

NPI: 1679777247
Provider Name (Legal Business Name): ARIEL E HOLLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 LAKE BOONE TRL STE 300
RALEIGH NC
27607-7514
US

IV. Provider business mailing address

PO BOX 12860
BELFAST ME
04915-4019
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-5510
  • Fax: 919-781-5053
Mailing address:
  • Phone: 199-781-5510
  • Fax: 919-781-5053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberN4475
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberBP1-0026565
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number2019-01647
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: