Provider Demographics
NPI:1083638043
Name:HOLETS, HENRY ERNEST (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:ERNEST
Last Name:HOLETS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1290 CHESS ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-2716
Mailing Address - Country:US
Mailing Address - Phone:724-258-7500
Mailing Address - Fax:724-258-3618
Practice Address - Street 1:1290 CHESS ST
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-2716
Practice Address - Country:US
Practice Address - Phone:724-258-7500
Practice Address - Fax:724-258-3618
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA017917E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC30020Medicare UPIN