Provider Demographics
NPI:1801810296
Name:HOLLANDER, EDWARD MARSHALL (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MARSHALL
Last Name:HOLLANDER
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 1:8 N POINTE CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-3187
Mailing Address - Country:US
Mailing Address - Phone:336-540-0360
Mailing Address - Fax:
Practice Address - Street 1:8 N POINTE CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-3187
Practice Address - Country:US
Practice Address - Phone:336-274-4626
Practice Address - Fax:336-274-7952
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17174174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC80611Medicare UPIN