Individual
ROBERT M HOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 JEFFERSON AVE, PT PLEASANT, WV 25550
(304) 675-1675
(304) 675-3713
Mailing address
2500 JEFFERSON AVE, PT PLEASANT, WV 25550
(304) 675-1675
(304) 675-3713
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11422
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720019
BCBS
WV
05
—
0050184000
—
WV
05
—
0730678
—
OH
01
—
550609268
AETNA
WV
01
—
55060926800
WV COMPENSATION
WV
Enumeration date
09/21/2006
Last updated
08/16/2010
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