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NPI Code Detail

MEDICARE: DR. JEANNE MARIE HOLUP MD

MEDICARE: DR. JEANNE MARIE HOLUP MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician35078158OH

General Provider Information

NPI Number : 1609802743
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEANNE MARIE HOLUP MD
Provider Business Mailing Address
First Line : 434 EASTLAND RD
Second Line :
City : BEREA
State : OH
Zip : 44017-1217
Country : US
Telephone Number : 440-260-8327
Fax Number :
Provider Business Practice Location Address
First Line : 885 COMMERCE DR
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-5267
Country : US
Telephone Number : 440-234-2006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 10/25/2021

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