Provider Demographics
NPI:1760485122
Name:BROWN, JEFFREY J (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:J
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1838 GREENE TREE RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208
Mailing Address - Country:US
Mailing Address - Phone:410-602-9272
Mailing Address - Fax:410-602-9276
Practice Address - Street 1:9105 FRANKLIN SQUARE DR
Practice Address - Street 2:STE 209
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3958
Practice Address - Country:US
Practice Address - Phone:410-574-1330
Practice Address - Fax:410-574-2691
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2010-08-30
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Provider Licenses
StateLicense IDTaxonomies
MDD0035157207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD279851400Medicaid
MD000L235XMedicare ID - Type Unspecified
MD279851400Medicaid