Healthcare Provider Details

I. General information

NPI: 1053705384
Provider Name (Legal Business Name): NEAL JOSHUA DOLLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 MACK RD STE 310
FAIRFIELD OH
45014-5376
US

IV. Provider business mailing address

3050 MACK RD STE 310
FAIRFIELD OH
45014-5376
US

V. Phone/Fax

Practice location:
  • Phone: 513-952-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35-12-9398
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number35.129398
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: