Provider Demographics
NPI:1699715516
Name:HOLLAND, JOHN RAMEY (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:RAMEY
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:840 FIRST COLONIAL RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6106
Mailing Address - Country:US
Mailing Address - Phone:757-422-2212
Mailing Address - Fax:757-422-9177
Practice Address - Street 1:113 GAINSBOROUGH SQ
Practice Address - Street 2:SUITE 103
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1713
Practice Address - Country:US
Practice Address - Phone:757-548-1038
Practice Address - Fax:757-548-3733
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101037815208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC36650Medicare UPIN