Healthcare Provider Details

I. General information

NPI: 1063465193
Provider Name (Legal Business Name): DAWN HOLMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 PARK BLVD
MARION VA
24354-4103
US

IV. Provider business mailing address

239 PARK BLVD
MARION VA
24354-4103
US

V. Phone/Fax

Practice location:
  • Phone: 276-378-0075
  • Fax: 855-318-0701
Mailing address:
  • Phone: 276-378-0075
  • Fax: 855-318-0701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101262322
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: