Provider Demographics
NPI:1063680882
Name:BROWN, CRAIG MITCHELL (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:MITCHELL
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1240 JESSE JEWELL PKWY SE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3862
Mailing Address - Country:US
Mailing Address - Phone:770-536-9864
Mailing Address - Fax:770-297-5012
Practice Address - Street 1:1240 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE 500
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3862
Practice Address - Country:US
Practice Address - Phone:770-536-9864
Practice Address - Fax:770-297-5012
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2020-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA62478207RC0200X
NY238219207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11628634OtherCAQH