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Organization

HOLMES & GUY PODIATRISTS, P C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDNA C HOLMES DPM (OWNER)
(703) 494-3070
Entity
Organization

Contact information

Practice address
1700 ROSEDALE CT, WOODBRIDGE, VA 22191-3016
(703) 494-3070
Mailing address
1700 ROSEDALE CT, WOODBRIDGE, VA 22191-3016

Taxonomy

Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
026083
BLUE CROSS BLUE SHIELD
01
480000105
MEDICARE PTAN
01
5407
DC PROVIDER NUMBER
05
9302409
VA
01
C11074
PTAN
VA
Enumeration date
11/02/2009
Last updated
06/22/2010
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