Provider Demographics
NPI:1316956535
Name:DOWLING, BRIAN PATRICK (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:PATRICK
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 1:4075 OLD WESTERN ROW RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-3104
Mailing Address - Country:US
Mailing Address - Phone:513-536-0628
Mailing Address - Fax:513-536-0619
Practice Address - Street 1:4075 OLD WESTERN ROW RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3104
Practice Address - Country:US
Practice Address - Phone:513-536-0628
Practice Address - Fax:513-536-0619
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH858632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000374942OtherANTHEM
OH9356701Medicare PIN
BR9356701Medicare PIN
OHDO4159332Medicare PIN
OH4159332Medicare PIN
OHI30635Medicare UPIN