Provider Demographics
NPI:1871612499
Name:HOLSHUER, DONNA JEAN III
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:JEAN
Last Name:HOLSHUER
Suffix:III
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43777-9732
Mailing Address - Country:US
Mailing Address - Phone:740-849-3008
Mailing Address - Fax:
Practice Address - Street 1:3655 CHARLES ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43777-9732
Practice Address - Country:US
Practice Address - Phone:740-849-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2251254251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2251254Medicare UPIN