MEDICARE: MR. DONALD HOLZER MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	0101234003	VA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00022532	OTHER	VA	MEDICARE RAILROAD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0500834	OTHER		TRICARE STANDARD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	150684200	OTHER		OWCP
4	54-1951442	OTHER		MIDATLANTIC HEALTH SOLUTI
6	465352	OTHER		ANTHEM
7	0500834	OTHER	VA	PHYSICIAN NETWORK
8	54-1951442	OTHER	VA	HEALTH NETWORK
9	465352	OTHER	VA	BCBS
10	54-1951442	OTHER		BENESIGHT
11	6086731015	OTHER		CIGNA
12	465352	OTHER		HEALTHKEEPERS
13	465352	OTHER		PENINSULA HEALTHCARE INC
14	465352	OTHER		PRIORITY HEALTH CARE INC
15	54-1951442	OTHER		FOCUS
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	54-1951442	OTHER		CORVEL WC PROVIDER NETWOR
18	69674	OTHER		SENTRA

NPI Number	:	1295727105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD HOLZER MD

Provider Business Mailing Address
First Line	:	3315 HIGH ST
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-3319
Country	:	US
Telephone Number	:	757-399-0759
Fax Number	:	757-397-8957

Provider Business Practice Location Address
First Line	:	3315 HIGH ST
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-3319
Country	:	US
Telephone Number	:	757-399-0759
Fax Number	:	757-397-8957

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

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	03/24/2011

3315 HIGH ST , THE CENTER FOR PAIN MANAGEMENT
PORTSMOUTH, VA
23707-3319

Practice Phone: 757-399-0759
Practice Fax: 757-397-8951