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General NPI Number Information
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NPI Number | 1871840504
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Entity Type | Individual
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Provider Name | MATTHEW DONALD HOLTKAMP D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 9040 JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 253-968-3885
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Fax |
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Provider Business Mailing Address
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Address Line | 8901 WISCONSIN AVE DEPARTMENT OF NEUROLOGY
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City | BETHESDA
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State | MD
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Zip | 20814
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Country | US
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Telephone | 301-295-4771
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 0102203680
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License Number State | VA
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