MEDICARE: BETH L. HOLTHUSEN PA

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	363A00000X	Physician Assistant	100852	NC

General Provider Information

NPI Number	:	1467424515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH L. HOLTHUSEN PA

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	336-774-9000
Fax Number	:	336-774-9012

Provider Business Practice Location Address
First Line	:	201 EXECUTIVE PARK BLVD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-1503
Country	:	US
Telephone Number	:	336-774-9000
Fax Number	:	336-774-9012

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	10/29/2020

Similar Medicare Providers

1811989072 — DEIRDRE A HERRINGTON MD, LTD
Practice Location Address:

201 EXECUTIVE PARK BLVD
WINSTON-SALEM, NC
27103-1503

Practice Phone: 336-774-0290
Practice Fax: 336-774-9012

1003895889 — D R BLAND MD PA
Practice Location Address:

201 EXECUTIVE PARK BLVD
WINSTON SALEM, NC
27103-1503

Practice Phone: 336-774-9000
Practice Fax:

1033160098 — DR. LINN HAYNES PARSONS MD
Practice Location Address:

201 EXECUTIVE PARK BLVD
WINSTON-SALEM, NC
27103-1503

Practice Phone: 336-774-9000
Practice Fax: 336-774-9012

1972639854 — TONI WYMER, M.D. LTD
Practice Location Address:

201 EXECUTIVE PARK BLVD
WINSTON SALEM, NC
27103-1503

Practice Phone: 336-774-0920
Practice Fax: 336-774-9012

1346424744 — DR. DEIRDRE HERRINGTON MD
Practice Location Address:

201 EXECUTIVE PARK BLVD
WINSTON SALEM, NC
27103-1503

Practice Phone: 336-774-9000
Practice Fax: 336-774-9012

1497939995 — DR. DEIRDRE R BLAND MD
Practice Location Address:

201 EXECUTIVE PARK BLVD
WINSTON SALEM, NC
27103-1503

Practice Phone: 336-774-9000
Practice Fax: 336-774-9012

Directions to “ BETH L. HOLTHUSEN PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.