Individual
DR. ALLEN J HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
265 RACINE DR STE 102, WILMINGTON, NC 28403-8745
(910) 399-6661
Mailing address
265 RACINE DR STE 102, WILMINGTON, NC 28403-8745
(910) 399-6661
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200500319
NC
207P00000X
Emergency Medicine Physician
22253
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952441842
CHAMPUS
NC
05
—
1952441842
—
WV
05
—
2795855
—
OH
05
—
5900923
—
NC
05
—
7100040000
—
KY
01
—
P00387855
MEDICARE-RR PROVIDER NUMBER
WV
01
—
P01165075
RAILROAD MEDICARE
NC
Enumeration date
02/08/2007
Last updated
08/30/2023
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