MEDICARE: DR. HOLLY J COWARD M.D.

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	34286	NC

General Provider Information

NPI Number	:	1306891007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOLLY J COWARD M.D.

Provider Business Mailing Address
First Line	:	MEDICAL CENTER BLVD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:	919-370-7102
Fax Number	:	919-942-0377

Provider Business Practice Location Address
First Line	:	MEDICAL CENTER BLVD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-8471
Country	:	US
Telephone Number	:	336-716-2255
Fax Number	:

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

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	07/15/2019

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