Provider Demographics
NPI:1770577181
Name:HOLSINGER, BRIAN (DO)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:HOLSINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9480 ROSEMONT DR
Mailing Address - Street 2:STE 100
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241
Mailing Address - Country:US
Mailing Address - Phone:330-626-5566
Mailing Address - Fax:330-626-2042
Practice Address - Street 1:9480 ROSEMONT DR
Practice Address - Street 2:STE 100
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241
Practice Address - Country:US
Practice Address - Phone:330-626-5566
Practice Address - Fax:330-626-2042
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34007209H207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2186110Medicaid
OH2186110Medicaid
OHH00892921Medicare ID - Type Unspecified