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General NPI Number Information
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NPI Number | 1073652335
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Entity Type | Individual
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Provider Name | DONALD HOLCOMB II PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 415 MORRIS ST STE 300
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City | CHARLESTON
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State | WV
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Zip | 25301-1853
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Country | US
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Telephone | 304-388-6441
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Fax | 304-388-6445
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Provider Business Mailing Address
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Address Line | 415 MORRIS ST 300
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City | CHARLESTON
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State | WV
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Zip | 25301-1853
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Country | US
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Telephone | 304-388-6441
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Fax | 304-388-6445
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 973
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 00973
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License Number State | WV
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