Provider Demographics
NPI:1215904867
Name:OVERHOLT, VALERIE KAY (DO)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:KAY
Last Name:OVERHOLT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 OXFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT RIDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48069-1112
Mailing Address - Country:US
Mailing Address - Phone:248-543-5517
Mailing Address - Fax:
Practice Address - Street 1:47 OXFORD BLVD
Practice Address - Street 2:
Practice Address - City:PLEASANT RIDGE
Practice Address - State:MI
Practice Address - Zip Code:48069-1112
Practice Address - Country:US
Practice Address - Phone:248-543-5517
Practice Address - Fax:248-543-0031
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101008253207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine