Provider Demographics
NPI:1457479305
Name:BROWN, SANDRA EILEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:EILEEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:23077 GREENFIELD RD
Mailing Address - Street 2:SUITE #235
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3709
Mailing Address - Country:US
Mailing Address - Phone:248-557-1414
Mailing Address - Fax:248-557-2708
Practice Address - Street 1:23077 GREENFIELD RD
Practice Address - Street 2:SUITE #235
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3709
Practice Address - Country:US
Practice Address - Phone:248-557-1414
Practice Address - Fax:248-557-2708
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2015-02-18
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Provider Licenses
StateLicense IDTaxonomies
MI4301045361207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0633650Medicare PIN