Provider Demographics
NPI:1225089261
Name:HOLLAND, ELBRIDGE T (MD)
Entity Type:Individual
Prefix:DR
First Name:ELBRIDGE
Middle Name:T
Last Name:HOLLAND
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 1:492 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2142
Mailing Address - Country:US
Mailing Address - Phone:973-635-2432
Mailing Address - Fax:973-635-6169
Practice Address - Street 1:492 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2142
Practice Address - Country:US
Practice Address - Phone:973-635-2432
Practice Address - Fax:973-635-6169
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ03212100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine