Provider Demographics
NPI:1316908221
Name:DOWLING, BRIAN GUY (DPM)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:GUY
Last Name:DOWLING
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-7028
Mailing Address - Country:US
Mailing Address - Phone:814-623-6191
Mailing Address - Fax:814-623-5519
Practice Address - Street 1:138 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-7028
Practice Address - Country:US
Practice Address - Phone:814-623-6191
Practice Address - Fax:814-623-5519
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01258213E00000X
WV335213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4526650001OtherDMERC
456543OtherMAMSI
54967902OtherBLLUE CROSS BLUE SHIELD
DC027460900Medicaid
WV4526650001OtherDMERC
WV0100074000Medicaid
MD022500200Medicaid
MD5658587OtherAETNA
R094OtherNATIONAL BLUE CROSS
MDU70359Medicare UPIN
DC027460900Medicaid
54967902OtherBLLUE CROSS BLUE SHIELD
R094OtherNATIONAL BLUE CROSS
MD5658587OtherAETNA