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Individual

AGNES E HOLLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10215 FERNWOOD RD, STE 50, BETHESDA, MD 20817
(301) 564-1053
(703) 280-5098
Mailing address
3015 WILLIAMS DRIVE, STE 200, FAIRFAX, VA 22031
(703) 641-9133
(703) 280-5098

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101240501
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10011034
SENTARA
VA
01
139178
BCBS
VA
05
1760572457
VA
05
5905226
NC
01
P00376889
RR MEDICARE
VA
Enumeration date
10/13/2006
Last updated
08/12/2008
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