Provider Demographics
NPI:1215993357
Name:DOWLING, KYRAN (MD)
Entity type:Individual
Prefix:
First Name:KYRAN
Middle Name:
Last Name:DOWLING
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 1:22 ROULSTON RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1209
Mailing Address - Country:US
Mailing Address - Phone:603-212-9856
Mailing Address - Fax:706-653-1162
Practice Address - Street 1:101 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3040
Practice Address - Country:US
Practice Address - Phone:864-560-6522
Practice Address - Fax:888-972-8644
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC282542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8929033Medicaid
SC282544Medicaid
SCP00262517Medicare PIN
SCF62697Medicare UPIN
SCF626977895Medicare PIN
SCP00326707Medicare PIN
SC282544Medicaid