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General NPI Number Information
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NPI Number | 1699702027
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Entity Type | Individual
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Provider Name | MICHELE H HOLLIS MD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 13860 WELLINGTON TRCE STE 38-153
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City | WELLINGTON
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State | FL
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Zip | 33414-8588
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Country | US
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Telephone | 804-350-7278
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Fax | 844-374-6554
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Provider Business Mailing Address
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Address Line | 19167 LAVAGA DR
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City | ROCKVILLE
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State | VA
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Zip | 23146-1557
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Country | US
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Telephone | 804-350-7278
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101234780
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101234780
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME108560
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License Number State | FL
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