MEDICARE: GEORGE THOMAS HOLLAND 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	207Q00000X	Family Medicine Physician	39512	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	080149894	OTHER	NC	RAILROAD ,MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20904	OTHER	NC	CIGNA
2	43093	OTHER	NC	BCBSNC
3	0128732	OTHER	NC	UNITED HEALTHCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	92258	OTHER	NC	MEDCOST
7	9663589	OTHER	NC	GHI
8	0054	OTHER	NC	AETNA

General Provider Information

NPI Number	:	1679550305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE THOMAS HOLLAND MD

Provider Business Mailing Address
First Line	:	PO BOX 96860
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28296-6860
Country	:	US
Telephone Number	:	910-754-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	924 N HOWE ST
Second Line	:
City	:	SOUTHPORT
State	:	NC
Zip	:	28461-3038
Country	:	US
Telephone Number	:	910-457-3800
Fax Number	:	910-457-7066

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	06/04/2025

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Directions to “ GEORGE THOMAS HOLLAND MD” Practice Location

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