Provider Demographics
NPI:1821136466
Name:HOLLAND, ELWOOD SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ELWOOD
Middle Name:SAMUEL
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6005 LANDOVER RD
Mailing Address - Street 2:STE. 3
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1145
Mailing Address - Country:US
Mailing Address - Phone:301-341-1177
Mailing Address - Fax:301-341-5659
Practice Address - Street 1:6005 LANDOVER RD
Practice Address - Street 2:STE. 3
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1145
Practice Address - Country:US
Practice Address - Phone:301-341-1177
Practice Address - Fax:301-341-1244
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD20989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
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2107922OtherAETNA INS.
MD0100881OtherUNITED HEALTHCARE OF THE MID-ATLANTIC,INC.
DC080187474OtherRAILROAD MEDICARE
DC0795OtherBCBSNCA
MD322601OtherOPTIMUM CHOICE, INC.
MD188621500Medicaid
MDAS77789810001OtherCIGNA HEALTHCARE
MD4296OtherBCBS (CAREFIRST)
AH7782596OtherDEA
MDC62626Medicare UPIN
DC410059Medicare PIN