Provider Demographics
NPI:1952369167
Name:HOLMES, JOSEPH NATHAN (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:NATHAN
Last Name:HOLMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:NATHAN
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:221 JAKE ALEXANDER BLVD S
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-9052
Mailing Address - Country:US
Mailing Address - Phone:704-216-0227
Mailing Address - Fax:704-216-0230
Practice Address - Street 1:221 JAKE ALEXANDER BLVD S
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-9052
Practice Address - Country:US
Practice Address - Phone:704-216-0227
Practice Address - Fax:704-216-0230
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2341736Medicare ID - Type Unspecified
NCD92890Medicare UPIN