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Individual

BRIAN THIENEMANN MACDOWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4724 DOVER ST NE, SAINT PETERSBURG, FL 33703-2138
(828) 778-8666
Mailing address
4724 DOVER ST NE, SAINT PETERSBURG, FL 33703
(828) 778-8666

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30836
NC
207RA0401X
Addiction Medicine (Internal Medicine) Physician
ME130669
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0171620
UHC
NC
05
10535300
FL
01
53676
BCBS
NC
05
8953676
NC
Enumeration date
04/13/2006
Last updated
03/25/2026
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