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Individual

BRIAN D CALDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 522-0320
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
(419) 522-0320

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50001773
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0075956
OH
Enumeration date
09/13/2006
Last updated
10/30/2024
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