Provider Demographics
NPI:1881657187
Name:BROWN, ANDREA (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HEALTHCARE DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3747
Mailing Address - Country:US
Mailing Address - Phone:207-282-9080
Mailing Address - Fax:207-282-9180
Practice Address - Street 1:4 SHAPE DR
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6601
Practice Address - Country:US
Practice Address - Phone:207-467-8988
Practice Address - Fax:207-467-8969
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME022169OtherANTHEM
ME7467323OtherCIGNA
ME267410099Medicaid
ME3422455OtherAETNA
MEAA4699OtherHARVARD PILGRIM
MEME0302Medicare ID - Type Unspecified
H99092Medicare UPIN
ME267410099Medicaid