Provider Demographics
NPI:1174646988
Name:BROWN, ROBERT BEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 MAIN ST
Mailing Address - Street 2:ST. VINCENT'S MEDICAL CENTER
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-4201
Mailing Address - Country:US
Mailing Address - Phone:203-576-5711
Mailing Address - Fax:203-576-5022
Practice Address - Street 1:2800 MAIN ST
Practice Address - Street 2:ST. VINCENT'S MEDICAL CENTER
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-4201
Practice Address - Country:US
Practice Address - Phone:203-576-5711
Practice Address - Fax:203-576-5022
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030178207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
D91681Medicare UPIN
290000189Medicare ID - Type Unspecified