Provider Demographics
NPI:1255360582
Name:BROWN, MARK S (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:BROWN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:EASTERN MAINE MEDICAL CENTER-489 STATE STREET
Mailing Address - Street 2:KELL-6
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-973-8670
Mailing Address - Fax:207-973-5163
Practice Address - Street 1:NICU PROFESSIONAL SERVICES-EMMC
Practice Address - Street 2:489 STATE STREET
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-973-8670
Practice Address - Fax:207-973-5163
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
ME0170412080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE54502Medicare UPIN