Provider Demographics
NPI:1215905674
Name:HOLT, ELIZABETH HOPE (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:HOPE
Last Name:HOLT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:H
Other - Last Name:HOLT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PA
Mailing Address - Street 1:2709 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6462
Mailing Address - Country:US
Mailing Address - Phone:919-876-7692
Mailing Address - Fax:919-954-3365
Practice Address - Street 1:2709 BLUE RIDGE RD
Practice Address - Street 2:SUITE 320
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6462
Practice Address - Country:US
Practice Address - Phone:919-876-7692
Practice Address - Fax:919-954-3365
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32514207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8942978Medicaid
NC42978OtherBCBS
NC4600001549OtherRR MEDICARE
NC8942978Medicaid
E06706Medicare UPIN