Provider Demographics
NPI:1417988197
Name:NOELLE, HOLGER (MD)
Entity Type:Individual
Prefix:
First Name:HOLGER
Middle Name:
Last Name:NOELLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21785 FILIGREE CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6213
Mailing Address - Country:US
Mailing Address - Phone:703-554-1120
Mailing Address - Fax:703-554-1058
Practice Address - Street 1:21785 FILIGREE CT
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6213
Practice Address - Country:US
Practice Address - Phone:703-554-1120
Practice Address - Fax:703-554-1058
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010205778Medicaid
VA010205433Medicaid
VA010205450Medicaid
VA010205409Medicaid