Organization
HOLLOWAY EYECARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEIRDRE C HOLLOWAY MD (PRESIDENT)
(248) 569-5577
Entity
Organization
Contact information
Practice address
20905 GREENFIELD RD STE 301, SOUTHFIELD, MI 48075-5347
(248) 569-5577
(248) 569-6211
Mailing address
20905 GREENFIELD RD STE 301, SOUTHFIELD, MI 48075-5347
(248) 569-5577
(248) 569-6211
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
030365
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104924743
—
MI
01
—
1806355592
BLUE CROSS
MI
Enumeration date
09/20/2006
Last updated
12/10/2007
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