Healthcare Provider Details

I. General information

NPI: 1346215704
Provider Name (Legal Business Name): DEBORAH C HOLLAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 FIRST COLONIAL RD STE 112
VIRGINIA BEACH VA
23454-3172
US

IV. Provider business mailing address

933 FIRST COLONIAL RD STE 112
VIRGINIA BEACH VA
23454-3172
US

V. Phone/Fax

Practice location:
  • Phone: 757-226-7320
  • Fax: 757-226-7304
Mailing address:
  • Phone: 757-226-7320
  • Fax: 757-226-7304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101037163
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: