Provider Demographics
NPI:1962518787
Name:KARL W. HOLTZER, MD
Entity type:Organization
Organization Name:KARL W. HOLTZER, MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOLTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-405-0220
Mailing Address - Street 1:145 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-2952
Mailing Address - Country:US
Mailing Address - Phone:803-405-0220
Mailing Address - Fax:803-405-0222
Practice Address - Street 1:145 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-2952
Practice Address - Country:US
Practice Address - Phone:803-405-0220
Practice Address - Fax:803-405-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF89874Medicare UPIN