Healthcare Provider Details

I. General information

NPI: 1508984956
Provider Name (Legal Business Name): BRIAN A DOLSEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 11/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 N MCCORD RD
TOLEDO OH
43615-1753
US

IV. Provider business mailing address

2940 N MCCORD RD
TOLEDO OH
43615-1753
US

V. Phone/Fax

Practice location:
  • Phone: 419-842-3000
  • Fax: 419-842-3042
Mailing address:
  • Phone: 419-842-3000
  • Fax: 419-842-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.094130
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301079978
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number4301079978
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35094130
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: