Provider Demographics
NPI:1053338723
Name:HOWREN, PHILIP B (DO)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:B
Last Name:HOWREN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7123 PEARL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4944
Mailing Address - Country:US
Mailing Address - Phone:440-842-7990
Mailing Address - Fax:440-842-8835
Practice Address - Street 1:500 GYPSY LANE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44501
Practice Address - Country:US
Practice Address - Phone:330-884-1000
Practice Address - Fax:440-842-8835
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002560146D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH930046006OtherMEDICARE RR-GA
OH0354458Medicaid
OH0354558Medicaid
OH942460636341OtherCARESOURCE
OH942460636341OtherCARESOURCE
OH0354458Medicaid