Provider Demographics
NPI:1417954603
Name:MCFAWN, BRIANA L (MD)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:L
Last Name:MCFAWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4421 EASTGATE BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-4500
Mailing Address - Country:US
Mailing Address - Phone:513-752-8000
Mailing Address - Fax:513-752-1078
Practice Address - Street 1:4421 EASTGATE BLVD
Practice Address - Street 2:STE 300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-4500
Practice Address - Country:US
Practice Address - Phone:513-752-8000
Practice Address - Fax:513-752-1078
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35081157M207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2333255Medicaid
1205887023OtherGROUP NPI
1205887023OtherGROUP NPI
OH4088522Medicare PIN