Provider Demographics
NPI:1982663324
Name:KILLIAN, PATRICK M (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:M
Last Name:KILLIAN
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 1:2000 AUBURN DR.
Mailing Address - Street 2:STE. 350
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4327
Mailing Address - Country:US
Mailing Address - Phone:440-646-1600
Mailing Address - Fax:440-646-1505
Practice Address - Street 1:4350 CROCKER ROAD
Practice Address - Street 2:STE 300
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6329
Practice Address - Country:US
Practice Address - Phone:440-588-8005
Practice Address - Fax:440-835-4790
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.081383207ND0101X
OH35081383207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0325301Medicaid
OH9295262OtherMEDICARE GROUP
OH9295262OtherMEDICARE GROUP