Provider Demographics
NPI:1639803653
Name:HOLMES, DEMETRIA SHERVON (RMA)
Entity Type:Individual
Prefix:
First Name:DEMETRIA
Middle Name:SHERVON
Last Name:HOLMES
Suffix:
Gender:F
Credentials:RMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1227 ROCKBRIDGE RD STE 397
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3064
Mailing Address - Country:US
Mailing Address - Phone:678-727-6967
Mailing Address - Fax:
Practice Address - Street 1:233 TRADITIONS LN
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-1710
Practice Address - Country:US
Practice Address - Phone:678-727-6967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy