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General NPI Number Information
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NPI Number | 1104446244
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Entity Type | Individual
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Provider Name | DEAN HOLLIDAY JR. MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2020
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 3300 BUCKEYE RD STE 178
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City | ATLANTA
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State | GA
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Zip | 30341-4232
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Country | US
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Telephone | 203-216-6626
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Fax |
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Provider Business Mailing Address
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Address Line | 1161 21ST AVE S
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City | NASHVILLE
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State | TN
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Zip | 37232-2561
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Country | US
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Telephone | 615-322-5769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 103744
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License Number State | GA
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