Healthcare Provider Details

I. General information

NPI: 1265657498
Provider Name (Legal Business Name): DENISE OPHELIA HOLMES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8220 WHISPERING PINES DR
NOVELTY OH
44072-9535
US

IV. Provider business mailing address

8220 WHISPERING PINES DRIVE
NOVELTY OH
44072
US

V. Phone/Fax

Practice location:
  • Phone: 440-338-5827
  • Fax: 440-338-6703
Mailing address:
  • Phone: 440-338-5827
  • Fax: 440-338-6703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35.056655
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: