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General NPI Number Information
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NPI Number | 1477524783
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Entity Type | Individual
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Provider Name | JOHN PLUMMER HOLT M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 2600 ATLANTIC AVE
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City | RALEIGH
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State | NC
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Zip | 27604-1502
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Country | US
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Telephone | 919-881-9999
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Fax | 919-881-9998
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Provider Business Mailing Address
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Address Line | 540 VISTA DEL LAGO LN
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City | WAKE FOREST
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State | NC
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Zip | 27587-5340
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Country | US
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Telephone | 919-664-2867
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 31724
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License Number State | NC
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