Provider Demographics
NPI:1235109844
Name:HOLLAND, DENISE EDGECOMBE (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:EDGECOMBE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ROSALYN
Other - Middle Name:DENISE
Other - Last Name:EDGECOMBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1610 CHAPEL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1763
Mailing Address - Country:US
Mailing Address - Phone:301-237-5425
Mailing Address - Fax:443-517-6864
Practice Address - Street 1:1610 CHAPEL RIDGE CT
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1763
Practice Address - Country:US
Practice Address - Phone:301-237-5425
Practice Address - Fax:443-517-6864
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC108252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C89072Medicare UPIN