Provider Demographics
NPI:1437260759
Name:HOLLOWAY-ANTHONY, CONCETTA RENEE (DO)
Entity Type:Individual
Prefix:DR
First Name:CONCETTA
Middle Name:RENEE
Last Name:HOLLOWAY-ANTHONY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:CONCETTA
Other - Middle Name:RENEE
Other - Last Name:HOLLOWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3905 WOODREED DR
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-6005
Mailing Address - Country:US
Mailing Address - Phone:301-292-7563
Mailing Address - Fax:301-292-5273
Practice Address - Street 1:3905 WOODREED DR
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-6005
Practice Address - Country:US
Practice Address - Phone:301-292-7563
Practice Address - Fax:301-292-5273
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0064572208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery