Provider Demographics
NPI:1104446244
Name:HOLLIDAY, DEAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:
Last Name:HOLLIDAY
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 21ST AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-2561
Mailing Address - Country:US
Mailing Address - Phone:615-322-5769
Mailing Address - Fax:
Practice Address - Street 1:3300 BUCKEYE RD STE 178
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4232
Practice Address - Country:US
Practice Address - Phone:203-216-6626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-18
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA103744207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology