Healthcare Provider Details

I. General information

NPI: 1124083498
Provider Name (Legal Business Name): THOMAS EDWARD HOLTHUS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 03/06/2021
Certification Date: 03/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33674 OLD VALLEY PIKE
STRASBURG VA
22657-3704
US

IV. Provider business mailing address

33674 OLD VALLEY PIKE
STRASBURG VA
22657-3704
US

V. Phone/Fax

Practice location:
  • Phone: 540-465-3751
  • Fax: 540-465-5008
Mailing address:
  • Phone: 540-465-3751
  • Fax: 540-465-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102036845
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: