Provider Demographics
NPI:1174525000
Name:BROWNELL, MARK D (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:D
Last Name:BROWNELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 20452
Mailing Address - Street 2:CORPATH-CRED
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-457-8180
Mailing Address - Fax:614-583-3300
Practice Address - Street 1:3535 OLENTANGY RIVER RD
Practice Address - Street 2:RMH PATHOLOGY DEPT - CORPATH
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3908
Practice Address - Country:US
Practice Address - Phone:614-566-4945
Practice Address - Fax:614-263-1056
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2023-05-01
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Provider Licenses
StateLicense IDTaxonomies
OH35055158207ZP0101X, 207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000208055OtherANTHEM BCBS
OH0679645Medicaid
OH0679645Medicaid
OH220022951OtherRAILROAD MEDICARE
OHC04308Medicare UPIN