Provider Demographics
NPI:1134483860
Name:HOLT, HARRY R (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:R
Last Name:HOLT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 FLEET ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4200
Mailing Address - Country:US
Mailing Address - Phone:410-558-4900
Mailing Address - Fax:410-522-1475
Practice Address - Street 1:3700 FLEET ST STE 200
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4243
Practice Address - Country:US
Practice Address - Phone:410-558-4900
Practice Address - Fax:410-522-1475
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0083150207Q00000X
VA0101257345207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine