Basic Information
Provider Information
NPI: 1962619825
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DWINELL
FirstName: BRIAN
MiddleName: THOMAS SILVER CLOUD
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DWINELL
OtherFirstName: SILVER
OtherMiddleName: CLOUD
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 2
Mailing Information
Address1: 300 SOUTH ARLINGTON AVENUE
Address2:  
City: RENO
State: NV
PostalCode: 895012002
CountryCode: US
TelephoneNumber: 7753481900
FaxNumber: 7753481904
Practice Location
Address1: 235 WEST SIXTH STREET
Address2: SAINT MARYS REGIONAL MEDICAL CENTER
City: RENO
State: NV
PostalCode: 895034548
CountryCode: US
TelephoneNumber: 7757703000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/17/2007
LastUpdateDate: 09/28/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X12430NVY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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