Provider Demographics
NPI:1477599959
Name:HOLEHOUSE, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:HOLEHOUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-1141
Mailing Address - Country:US
Mailing Address - Phone:304-333-8385
Mailing Address - Fax:304-333-8332
Practice Address - Street 1:51 SOUTHLAND DR
Practice Address - Street 2:SUITE 3200
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-2244
Practice Address - Country:US
Practice Address - Phone:304-333-8385
Practice Address - Fax:304-333-8332
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15258207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0091377000Medicaid
WV001710365OtherBCBS FOR PMMG
WVWV15258COtherHEALTHPLAN PMMG
WV0650017Medicare PIN
WVD49537Medicare UPIN
WVHO0650014Medicare PIN