Provider Demographics
NPI:1457371809
Name:HOLMES, BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:301-797-9240
Mailing Address - Fax:301-797-4234
Practice Address - Street 1:17 WESTERN MARYLAND PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5471
Practice Address - Country:US
Practice Address - Phone:301-797-9240
Practice Address - Fax:301-797-4234
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052346L207T00000X
MDD0059392207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA194525OtherPA BLUE SHIELD PA LOCATIO
MD61732301OtherMD BLUE SHIELD TRADITIONA
P00002484OtherRR MEDICARE
PA1414266OtherPA BLUE SHIELD MD LOCATIO
MDW2660005OtherMD BLUE SHIELD REGIONAL
MD402172000Medicaid
PA1414266OtherPA BLUE SHIELD MD LOCATIO
MDF04307Medicare UPIN
MD602LE818Medicare PIN
MD602LE818Medicare PIN