Individual
BRIAN POWDERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2675 36TH ST, PARKERSBURG, WV 26104-8024
(304) 422-8112
(304) 422-3924
Mailing address
301 SAINT ANDREWS BLVD, BELPRE, OH 45714-9327
(304) 422-8112
(304) 422-3924
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14380
WV
207Q00000X
Family Medicine Physician
35076176P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000147520
MS BCBS
—
05
—
0057420000
—
WV
01
—
110019344
RR MEDICARE
—
05
—
2125417
—
OH
Enumeration date
03/02/2006
Last updated
07/13/2023
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