MEDICARE: ALBERT Z HOLLOWAY 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	2080A0000X	Pediatric Adolescent Medicine Physician	8318	AL

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831298355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERT Z HOLLOWAY MD

Provider Business Mailing Address
First Line	:	PO BOX 70365
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36107-0365
Country	:	US
Telephone Number	:	334-420-5001
Fax Number	:	334-420-0158

Provider Business Practice Location Address
First Line	:	2611 WOODLEY PARK DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-3834
Country	:	US
Telephone Number	:	334-420-5001
Fax Number	:	334-420-0158

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	01/07/2011

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Directions to “ ALBERT Z HOLLOWAY MD” Practice Location

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