Provider Demographics
NPI:1962496455
Name:HOLT, TRUDI KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:TRUDI
Middle Name:KAY
Last Name:HOLT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 JONES RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-6603
Mailing Address - Country:US
Mailing Address - Phone:214-912-5811
Mailing Address - Fax:
Practice Address - Street 1:1000 N SHENANDOAH AVE
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3547
Practice Address - Country:US
Practice Address - Phone:540-636-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036308207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine