Individual
ROBERT HOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 376-1939
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5201
(740) 446-5761
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34006443
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000360722
OH MEDICAID UNISON
OH
01
—
000000361214
IND BC/BS # AT GRADY
OH
05
—
0459016
—
OH
01
—
310917085154
OH MEDICAID CARESOURCE
OH
05
—
3810007936
—
WV
01
—
459016
OH MEDICAID MOLINA
OH
01
—
P00241147
IND RRMEDICARE # AT GRADY
OH
01
—
P00884478
RAIL ROAD MEDICARE
OH
Enumeration date
04/13/2006
Last updated
02/26/2024
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