Provider Demographics
NPI:1689945081
Name:BROWN, TYLER S (MD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:S
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVENUE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:617-414-5405
Mailing Address - Fax:617-414-6031
Practice Address - Street 1:801 MASSACHUSETTS AVE STE 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2605
Practice Address - Country:US
Practice Address - Phone:617-414-7019
Practice Address - Fax:617-414-2875
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2023-05-02
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Provider Licenses
StateLicense IDTaxonomies
MA277435207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA101125401AMedicaid