Provider Demographics
NPI:1215290358
Name:HOLZSHU, ROBERT (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:HOLZSHU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 S 8TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2752
Mailing Address - Country:US
Mailing Address - Phone:717-414-7798
Mailing Address - Fax:717-414-7942
Practice Address - Street 1:144 S 8TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2755
Practice Address - Country:US
Practice Address - Phone:717-414-7798
Practice Address - Fax:717-414-7942
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS018365207QS0010X
PA390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA561956YJDCMedicare PIN