Provider Demographics
NPI:1083828180
Name:HOLZER, ATON MORDECHAI (MD)
Entity Type:Individual
Prefix:
First Name:ATON
Middle Name:MORDECHAI
Last Name:HOLZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:774 CHRISTIANA RD STE 107
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4248
Mailing Address - Country:US
Mailing Address - Phone:302-230-3376
Mailing Address - Fax:302-224-4990
Practice Address - Street 1:774 CHRISTIANA RD STE 107
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4248
Practice Address - Country:US
Practice Address - Phone:302-230-3376
Practice Address - Fax:302-224-4990
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110136207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFD484ZMedicare PIN