Provider Demographics
NPI:1588430920
Name:HOLZEMER, BAHAR F
Entity type:Individual
Prefix:
First Name:BAHAR
Middle Name:F
Last Name:HOLZEMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9161 LIBERIA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-1724
Mailing Address - Country:US
Mailing Address - Phone:703-420-2722
Mailing Address - Fax:703-420-2681
Practice Address - Street 1:9161 LIBERIA AVE
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-1723
Practice Address - Country:US
Practice Address - Phone:703-420-2722
Practice Address - Fax:703-420-2681
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121001137171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist