Individual
MICHAEL RAY HOLTGREWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 MATTHEW ST, WOUND CARE CENTER, MARIETTA, OH 45750-1635
(740) 374-1623
(740) 568-5355
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887
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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