Individual
DR. REGINA LORREN HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
308 CARROLLTON STREET, BREMEN, GA 30110
(770) 537-1960
(770) 537-1901
Mailing address
308 CARROLLTON STREET, BREMEN, GA 30110
(770) 537-1960
(770) 537-1901
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
034852
GA
207Q00000X
Family Medicine Physician
Primary
034852
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00478552H
—
GA
01
—
021201960A
CAID PAYEE
GA
01
—
142710464A
GBHC
GA
Enumeration date
11/14/2006
Last updated
07/14/2010
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