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Individual

MICHAEL RAY HOLTGREWE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35.043477
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000727930
ANTHEM
OH
01
000000728056
ANTHEM
OH
05
0041480000
WV
05
0397324
OH
01
P01254615
RAILROAD MEDICARE - MHCPI
OH
Enumeration date
06/14/2005
Last updated
02/17/2014
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