Basic Information
Provider Information | |||||||||
NPI: | 1609848555 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | BILHORN | ||||||||
FirstName: | DENISE | ||||||||
MiddleName: | HOLLOMAN | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 915 TATE BLVD SE | ||||||||
Address2: | SUITE 170 | ||||||||
City: | HICKORY | ||||||||
State: | NC | ||||||||
PostalCode: | 286024042 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8283450800 | ||||||||
FaxNumber: | 8283450350 | ||||||||
Practice Location | |||||||||
Address1: | 915 TATE BLVD SE | ||||||||
Address2: | SUITE 170 | ||||||||
City: | HICKORY | ||||||||
State: | NC | ||||||||
PostalCode: | 286024042 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8283450800 | ||||||||
FaxNumber: | 8283450350 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/05/2006 | ||||||||
LastUpdateDate: | 08/15/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 2006-00001 | NC | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
ID Information
ID | Type | State | Issuer | Description | AM1768019 | 01 | NC | DEA | OTHER | 2006-00001 | 01 | NC | NC LICENSE | OTHER |