Provider Demographics
NPI:1396420345
Name:HOLLOMAN, DION
Entity type:Individual
Prefix:
First Name:DION
Middle Name:
Last Name:HOLLOMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 ATWOOD ST APT 5
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1622
Mailing Address - Country:US
Mailing Address - Phone:240-556-4472
Mailing Address - Fax:
Practice Address - Street 1:4671 BENNING RD SE APT A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5186
Practice Address - Country:US
Practice Address - Phone:202-766-4527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant