Provider Demographics
NPI:1679519979
Name:BROWN, WILLIAM CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHRISTOPHER
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 1:1385 E PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:OLD GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06870-1305
Mailing Address - Country:US
Mailing Address - Phone:203-863-1180
Mailing Address - Fax:203-863-1182
Practice Address - Street 1:1385 E PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870-1305
Practice Address - Country:US
Practice Address - Phone:203-863-1180
Practice Address - Fax:203-863-1182
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT31641174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
340000351Medicare PIN
CTD79762Medicare UPIN