Provider Demographics
NPI:1730142241
Name:HOLLAND, SONYA DENISE (DO)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:DENISE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2300 FALL HILL AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3342
Mailing Address - Country:US
Mailing Address - Phone:540-374-5097
Mailing Address - Fax:540-374-0378
Practice Address - Street 1:422 GARRISONVILLE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1573
Practice Address - Country:US
Practice Address - Phone:540-657-4800
Practice Address - Fax:540-657-4021
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2011-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102201597207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010085357Medicaid
VA010085357Medicaid
VAI23263Medicare UPIN