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DAMIAN FRANCIS DOLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
85 N GRAND AVE, FORT THOMAS, KY 41075-1793
(859) 572-3232
(859) 572-3727
Mailing address
20 MEDICAL VILLAGE DR, SUITE 258, EDGEWOOD, KY 41017-5401
(859) 341-7246
(859) 341-7867

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
38010
KY
207L00000X
Anesthesiology Physician
35060078D
OH
207L00000X
Anesthesiology Physician
Primary
38010
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000542722
ANTHEM
01
00000077646
ANTHEM BLUE SHIELD
05
0790934
OH
05
200366080
IN
01
50019772
PASSPORT HEALTH
05
64037930
KY
Enumeration date
11/16/2005
Last updated
05/12/2010
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