Provider Demographics
NPI:1467599449
Name:HOLMAN, SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:HOLMAN
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 1:30 GARFIELD ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2353
Mailing Address - Country:US
Mailing Address - Phone:828-254-3484
Mailing Address - Fax:828-254-3485
Practice Address - Street 1:30 GARFIELD ST STE A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-7301
Practice Address - Country:US
Practice Address - Phone:828-254-3484
Practice Address - Fax:828-254-3485
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC 028650174400000X
NC28650207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC45845Medicare UPIN