Provider Demographics
NPI:1932195948
Name:HOLLAND, SUSAN J (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:J
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 MUD RUN RD
Mailing Address - Street 2:
Mailing Address - City:YORK SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17372-9533
Mailing Address - Country:US
Mailing Address - Phone:540-220-0500
Mailing Address - Fax:
Practice Address - Street 1:51 W MIDDLE ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2102
Practice Address - Country:US
Practice Address - Phone:301-682-5683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD486218207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE03211Medicare UPIN
VA00W461S01Medicare PIN