Individual
MATTHEW BRADY HOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
155 MEMORIAL DR, PINEHURST, NC 28374-8710
(910) 715-2164
(910) 715-4493
Mailing address
PO BOX 8500, PINEHURST, NC 28374-8500
(910) 715-1010
(910) 715-1026
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2006-01784
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144AP
BCBS
NC
01
—
194239
MEDCOST PROVIDER #
NC
05
—
89066MR
—
NC
01
—
FH1100185
FIRSTCAROLINA
NC
01
—
N01784
SC MEDICAID
SC
01
—
P00364847
PALMETTO GOVT SERVICES
NC
Enumeration date
08/25/2005
Last updated
10/22/2024
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