Provider Demographics
NPI:1659570638
Name:JAMES A BROWN MD PC
Entity Type:Organization
Organization Name:JAMES A BROWN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-885-5110
Mailing Address - Street 1:22151 MOROSS
Mailing Address - Street 2:SUITE 234
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-885-5710
Mailing Address - Fax:313-885-8755
Practice Address - Street 1:22151 MOROSS
Practice Address - Street 2:SUITE 234
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-885-5710
Practice Address - Fax:313-885-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJB036646207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI209945Medicaid
MIOP2210071OtherMEDICARE
MIOP2210071OtherMEDICARE