Holthusen, Gregory Grant

Holthusen, Gregory Grant is an individual health care provider with primary practice located at 170 Kimel Park Dr , Winston-Salem NC 27103-6946. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Holthusen, Gregory Grant can be contacted via phone (336) 768-1270.

Contact Information

Primary practice address
170 Kimel Park Dr Winston-Salem NC 27103-6946
Fax: (336) 765-6375
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 17871 North Carolina

Profile Details

NPI number 1326003385
LBN Legal business name Holthusen, Gregory Grant
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Apr 8th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326003385 NPPES
North Carolina MEDICAID 89-43461

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