Provider Demographics
NPI:1689801789
Name:BROWN, PATRICK JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOSEPH
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 1:100 WELTON DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1336
Mailing Address - Country:US
Mailing Address - Phone:301-777-7900
Mailing Address - Fax:301-724-5590
Practice Address - Street 1:100 WELTON DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1336
Practice Address - Country:US
Practice Address - Phone:301-777-7900
Practice Address - Fax:301-724-5590
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI66765207N00000X
MI4301501511207N00000X
TXQ6738207N00000X
NE25810207N00000X
MN61522207N00000X
MDD0092595207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0092595OtherMD LICENSE
MD444662300Medicaid
MDFB6514043OtherDEA
MN1689801789Medicaid