Individual
JEFFREY HOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 MEDICAL PARK DR, WALTERBORO, SC 29488-5719
(843) 782-4141
(843) 549-7967
Mailing address
120 MEDICAL PARK DR, WALTERBORO, SC 29488-5719
(843) 782-4141
(843) 549-7967
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
19118
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8566
MEDICARE PTAN
SC
05
—
GP4508
—
SC
Enumeration date
01/05/2006
Last updated
02/06/2012
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