Provider Demographics
NPI:1225188998
Name:BROWN, MICHAEL DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2450 W HUNTING PARK AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:215-204-2679
Mailing Address - Fax:215-204-1784
Practice Address - Street 1:1700 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-3429
Practice Address - Country:US
Practice Address - Phone:215-204-2679
Practice Address - Fax:215-204-1784
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2018-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-042141-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine