Provider Demographics
NPI:1265668347
Name:HOLMES, KHARIA JENAI (MD)
Entity Type:Individual
Prefix:
First Name:KHARIA
Middle Name:JENAI
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19851 OBSERVATION DR STE 250
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4151
Mailing Address - Country:US
Mailing Address - Phone:301-972-0400
Mailing Address - Fax:301-916-1453
Practice Address - Street 1:19851 OBSERVATION DR STE 250
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4151
Practice Address - Country:US
Practice Address - Phone:301-972-0400
Practice Address - Fax:301-916-1453
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251576207R00000X
DCMD044870207R00000X
MDD76138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD307221YBDBMedicare PIN