Provider Demographics
NPI:1366420382
Name:CHESHIRE, BRIAN DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DOUGLAS
Last Name:CHESHIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7550 ASSUNTA CT
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-3069
Mailing Address - Country:US
Mailing Address - Phone:251-928-4944
Mailing Address - Fax:251-928-2086
Practice Address - Street 1:7550 ASSUNTA CT
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3069
Practice Address - Country:US
Practice Address - Phone:251-928-4944
Practice Address - Fax:251-928-2086
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL21118207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG59341Medicare UPIN