Provider Demographics
NPI:1609837509
Name:BROWN, LOREN D
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:D
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 LAUREL
Mailing Address - Street 2:SUITE A300 MEDICAL ONCOLOGY AND HEMATOLOGY
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314
Mailing Address - Country:US
Mailing Address - Phone:515-247-3970
Mailing Address - Fax:515-643-8819
Practice Address - Street 1:411 LAUREL
Practice Address - Street 2:SUITE A300 MEDICAL ONCOLOGY AND HEMATOLOGY
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314
Practice Address - Country:US
Practice Address - Phone:515-247-3970
Practice Address - Fax:515-643-8819
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01574207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1195602Medicaid
IA1195602Medicaid
E65286Medicare UPIN