MEDICARE: DR. DAVID A HOLLADAY 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	2085R0001X	Radiation Oncology Physician	033356	GA

General Provider Information

NPI Number	:	1972593028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID A HOLLADAY MD

Provider Business Mailing Address
First Line	:	PO BOX 934925
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-4925
Country	:	US
Telephone Number	:	404-501-6925
Fax Number	:	404-501-6930

Provider Business Practice Location Address
First Line	:	2675 N DECATUR RD STE G09
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-6130
Country	:	US
Telephone Number	:	404-501-6925
Fax Number	:	404-501-6930

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

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	07/21/2022

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