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General NPI Number Information
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NPI Number | 1629046479
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Entity Type | Organization
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Legal Business Name | ENT & AUDIOLOGY ASSOCIATES PLLC
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 3820 ED DR
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City | RALEIGH
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State | NC
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Zip | 27612-8037
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Country | US
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Telephone | 919-782-9003
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Fax | 919-782-9303
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Provider Business Mailing Address
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Address Line | 3820 ED DR
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City | RALEIGH
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State | NC
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Zip | 27612-8037
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Country | US
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Telephone | 919-782-9003
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Fax | 919-782-9303
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Authorized Official
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Title or Position | CO OWNER
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Name | DOUGLAS K HOLMES
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Credential | MD
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Telephone | 919-782-9003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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