Provider Demographics
NPI:1881622884
Name:BRIAN G DOWLING DPM PC
Entity type:Organization
Organization Name:BRIAN G DOWLING DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-777-7780
Mailing Address - Street 1:600 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-4551
Mailing Address - Country:US
Mailing Address - Phone:301-777-7780
Mailing Address - Fax:301-777-7790
Practice Address - Street 1:600 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-4551
Practice Address - Country:US
Practice Address - Phone:301-777-7780
Practice Address - Fax:301-777-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01258213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0100074000Medicaid
MD5658587OtherAETNA
MD022500200Medicaid
R094OtherFEDERAL BLUE CROSS
DC027460900Medicaid
54967902OtherBLUE CROSS BLUE SHIELD
456543OtherMAMSI
DP5175Medicare PIN
DC027460900Medicaid
WV0860684Medicare PIN
WV0100074000Medicaid
MD5658587OtherAETNA
WV9352181Medicare PIN
MD136329Medicare PIN