Provider Demographics
NPI:1972644300
Name:BROWN, MICHAEL E (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:347 CYPRESS STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:FORT BRAGG
Mailing Address - State:CA
Mailing Address - Zip Code:95437-5458
Mailing Address - Country:US
Mailing Address - Phone:707-964-1820
Mailing Address - Fax:707-961-2698
Practice Address - Street 1:347 CYPRESS STREET
Practice Address - Street 2:SUITE B
Practice Address - City:FORT BRAGG
Practice Address - State:CA
Practice Address - Zip Code:95437-5458
Practice Address - Country:US
Practice Address - Phone:707-964-1820
Practice Address - Fax:707-961-2698
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG190242084P0800X
CAG1902412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAB8254586OtherDEA
CAAB8254586OtherDEA