Provider Demographics
NPI:1841397601
Name:BROWN, EMMANUEL P (MD)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:P
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:PO BOX 4593
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-0593
Mailing Address - Country:US
Mailing Address - Phone:301-630-3900
Mailing Address - Fax:301-630-3901
Practice Address - Street 1:4467 OLD BRANCH AVE STE 207
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1854
Practice Address - Country:US
Practice Address - Phone:301-630-3900
Practice Address - Fax:301-630-3901
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD31152207R00000X
MDD0053941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC017145500Medicaid
G91758Medicare UPIN
DC017145500Medicaid