Provider Demographics
NPI:1063522449
Name:MCCURLEY-MARTIN, HOLLY RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:RENEE
Last Name:MCCURLEY-MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:RENEE
Other - Last Name:MCCURLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:629 CEDAR CREEK GRADE STE B
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2786
Practice Address - Country:US
Practice Address - Phone:540-678-3950
Practice Address - Fax:540-678-3954
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400712208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891369YMedicaid
NC891369YMedicaid
NCI08375Medicare UPIN