Provider Demographics
NPI:1053603514
Name:HOLINGA, ANDREA JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:JEAN
Last Name:HOLINGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 ATHENS AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-1113
Mailing Address - Country:US
Mailing Address - Phone:614-580-9395
Mailing Address - Fax:
Practice Address - Street 1:625 ATHENS AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226-1113
Practice Address - Country:US
Practice Address - Phone:614-580-9395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.091154208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice