Provider Demographics
NPI:1285695114
Name:CARLIN, BRIAN WINTRODE (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:WINTRODE
Last Name:CARLIN
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:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:INGOMAR
Mailing Address - State:PA
Mailing Address - Zip Code:15127-0174
Mailing Address - Country:US
Mailing Address - Phone:412-298-8944
Mailing Address - Fax:
Practice Address - Street 1:2030 ARDMORE BLVD
Practice Address - Street 2:STE 251
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-4652
Practice Address - Country:US
Practice Address - Phone:412-351-6545
Practice Address - Fax:412-351-6547
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2011-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027516E207RP1001X, 207RS0012X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009581710006Medicaid
PACA197312Medicare ID - Type Unspecified
B41111Medicare UPIN