Provider Demographics
NPI:1295791820
Name:HOLLAND, MATTHEW D (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:BUILDING 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031
Mailing Address - Country:US
Mailing Address - Phone:410-329-1071
Mailing Address - Fax:410-329-1054
Practice Address - Street 1:1460 PANTOPS MOUNTAIN PL STE 2B
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4600
Practice Address - Country:US
Practice Address - Phone:434-234-4910
Practice Address - Fax:434-327-1799
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101227851207L00000X, 207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ708951Medicaid
H60824Medicare UPIN