Provider Demographics
NPI:1083674154
Name:BROWN, STEVEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1300 N 12TH ST STE 605
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2850
Mailing Address - Country:US
Mailing Address - Phone:608-839-2668
Mailing Address - Fax:608-839-2067
Practice Address - Street 1:1300 N 12TH ST
Practice Address - Street 2:SUITE 605
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2848
Practice Address - Country:US
Practice Address - Phone:602-239-4567
Practice Address - Fax:602-239-2067
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2011-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ33866207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ936180Medicaid
H76980Medicare UPIN
Z104112Medicare PIN