Provider Demographics
NPI:1982644738
Name:KULWIN, DWIGHT R (MD)
Entity Type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:R
Last Name:KULWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1945 CEI DRIVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3311
Mailing Address - Country:US
Mailing Address - Phone:513-984-5133
Mailing Address - Fax:513-569-3941
Practice Address - Street 1:3219 CLIFTON AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3027
Practice Address - Country:US
Practice Address - Phone:513-618-3300
Practice Address - Fax:513-618-3305
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35043329207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH180026058OtherRAILROAD MEDICARE
00000021214OtherBCBS
KY64765589Medicaid
WV0010999000Medicaid
OH0398770Medicaid
IN100374140Medicaid
OH0465908Medicare PIN
00000021214OtherBCBS
IN100374140Medicaid
OH0465909Medicare PIN
OH0465906Medicare PIN