Healthcare Provider Details

I. General information

NPI: 1336255652
Provider Name (Legal Business Name): BRIAN J DONELAN M.D., F.A.C.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ARCH ST
AKRON OH
44304-1437
US

IV. Provider business mailing address

PO BOX 3542
AKRON OH
44309-3542
US

V. Phone/Fax

Practice location:
  • Phone: 330-376-7000
  • Fax: 330-376-1066
Mailing address:
  • Phone: 330-996-0347
  • Fax: 330-996-0359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35064892
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: