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Benjamin Carllee Holman

Radiology

Allopathic & Osteopathic Physicians

Johns Hopkins Radiology, 600 N. Wolf St., Baltimore, MD 21287-0001

PECOS Enrollment

This provider is enrolled in PECOS as BENJAMIN HOLMAN.

Based on the most recent information from CMS, provider Benjamin Carllee Holman is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1083830749
Provider Type
Individual
Full Name
Holman, Benjamin Carllee
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
4/18/2007
Last Updated
1/28/2015

Contact Information

Practice Location

Johns Hopkins Radiology, 600 N. Wolf St., Baltimore, MD 21287-0001

(410) 955-8450

Unlisted Fax

Mailing Location

813 S Glover St, Baltimore, MD 21224-3730

(901) 626-4521

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 48427 Tennessee
Code 2085R0202X	Description Radiology Allopathic & Osteopathic Physicians	License 20729 Mississippi

Benjamin Carllee Holman

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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Kwak, Stephen

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