Provider Demographics
NPI:1881661122
Name:HOLMES, PATRICK E (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:E
Last Name:HOLMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 FURMAN RD
Mailing Address - Street 2:STE 101A
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5049
Mailing Address - Country:US
Mailing Address - Phone:828-262-4402
Mailing Address - Fax:828-264-0490
Practice Address - Street 1:155 FURMAN RD STE 101A
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5049
Practice Address - Country:US
Practice Address - Phone:828-262-4402
Practice Address - Fax:828-264-0490
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95012782085N0904X, 2085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8943559Medicaid
NCG26834Medicare UPIN
NC2223467BMedicare ID - Type Unspecified