Provider Demographics
NPI:1568497766
Name:BROWN, GREGORY SCOTT (MD)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:SCOTT
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 1:4848 MCLEOD DR E
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2839
Mailing Address - Country:US
Mailing Address - Phone:989-793-6200
Mailing Address - Fax:989-793-9997
Practice Address - Street 1:4848 MCLEOD DR E
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2839
Practice Address - Country:US
Practice Address - Phone:989-793-6200
Practice Address - Fax:989-793-9997
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301041203207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OG36045OtherMEDICARE NUMBER
MI1430409Medicaid
B46379Medicare UPIN