Provider Demographics
NPI:1912084419
Name:DOWLING, SEAN W (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:W
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 1:34 SHELBURNE RD
Mailing Address - Street 2:RADIATION ONCOLOGY
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3628
Mailing Address - Country:US
Mailing Address - Phone:203-276-7886
Mailing Address - Fax:
Practice Address - Street 1:34 SHELBURNE RD
Practice Address - Street 2:RADIATION ONCOLOGY
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3628
Practice Address - Country:US
Practice Address - Phone:203-276-7886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0272002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001272004Medicaid
CTB38861Medicare UPIN
CT001272004Medicaid