Healthcare Provider Details

I. General information

NPI: 1750379194
Provider Name (Legal Business Name): G BLAIR DOWDEN III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BEAU DOWDEN M.D.

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 STONE ST
PORT HURON MI
48060-3520
US

IV. Provider business mailing address

1313 STONE ST
PORT HURON MI
48060-3520
US

V. Phone/Fax

Practice location:
  • Phone: 810-985-2620
  • Fax: 810-962-8290
Mailing address:
  • Phone: 810-985-2620
  • Fax: 810-962-8290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301088847
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: