Provider Demographics
NPI:1033260633
Name:BROWN, DAVID RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RICHARD
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:88 RAVENS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-8139
Mailing Address - Country:US
Mailing Address - Phone:505-989-8635
Mailing Address - Fax:844-218-9645
Practice Address - Street 1:435 SAINT MICHAELS DR STE B104
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7671
Practice Address - Country:US
Practice Address - Phone:505-820-9945
Practice Address - Fax:505-399-3116
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM87-210207YX0602X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM87-210OtherSTATE LICENSURE NUMBER
NM39156Medicaid
NMD43057Medicare UPIN