Provider Demographics
NPI:1942294681
Name:HOLLAND, MICHAEL D (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:HOLLAND
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:EASTERN NEPHROLOGY ASSOCIATES PLLC
Mailing Address - Street 2:1302 MEDICAL CENTER DRIVE
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-0200
Mailing Address - Country:US
Mailing Address - Phone:910-343-9800
Mailing Address - Fax:910-343-8650
Practice Address - Street 1:EASTERN NEPHROLOGY ASSOCIATES PLLC
Practice Address - Street 2:2021 NORTH POINT BLVD SUITE 106
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-2224
Practice Address - Country:US
Practice Address - Phone:843-663-1401
Practice Address - Fax:910-778-1433
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23848207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8943091Medicaid
NC43091OtherBCBSNC
NC25489OtherMEDCOST
NC5885355OtherCIGNA HEALTHCARE
NC110095566OtherRAILROAD MEDICARE
NC25489OtherMEDCOST
NC207327Medicare PIN