Provider Demographics
NPI:1164800645
Name:HOLMES, MARVETTE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARVETTE
Middle Name:
Last Name:HOLMES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CHUCK
Other - Middle Name:
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:412 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-3112
Mailing Address - Country:US
Mailing Address - Phone:404-493-2762
Mailing Address - Fax:
Practice Address - Street 1:412 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-3112
Practice Address - Country:US
Practice Address - Phone:404-493-2762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021185208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology