MEDICARE: DR. ELIZABETH HOPE HOLT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	32514	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	4600001549	OTHER	NC	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	42978	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1215905674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH HOPE HOLT MD

Provider Business Mailing Address
First Line	:	2709 BLUE RIDGE RD
Second Line	:	SUITE 320
City	:	RALEIGH
State	:	NC
Zip	:	27607-6462
Country	:	US
Telephone Number	:	919-876-7692
Fax Number	:	919-954-3365

Provider Business Practice Location Address
First Line	:	2709 BLUE RIDGE RD
Second Line	:	SUITE 320
City	:	RALEIGH
State	:	NC
Zip	:	27607-6462
Country	:	US
Telephone Number	:	919-876-7692
Fax Number	:	919-954-3365

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	08/16/2011

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