MEDICARE: BRIAN HOLSINGER DO

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
1	207Q00000X	Family Medicine Physician	34007209H	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770577181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN HOLSINGER DO

Provider Business Mailing Address
First Line	:	9480 ROSEMONT DR
Second Line	:	STE 100
City	:	STREETSBORO
State	:	OH
Zip	:	44241
Country	:	US
Telephone Number	:	330-626-5566
Fax Number	:	330-626-2042

Provider Business Practice Location Address
First Line	:	9480 ROSEMONT DR
Second Line	:	STE 100
City	:	STREETSBORO
State	:	OH
Zip	:	44241
Country	:	US
Telephone Number	:	330-626-5566
Fax Number	:	330-626-2042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	07/08/2007

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Directions to “ BRIAN HOLSINGER DO” Practice Location

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