Provider Demographics
NPI:1295881977
Name:BROWN, GINA M (MD)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:BROWN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 PROVIDENCE DR STE 358
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4627
Mailing Address - Country:US
Mailing Address - Phone:907-268-2067
Mailing Address - Fax:855-395-0858
Practice Address - Street 1:3340 PROVIDENCE DR STE A358
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4691
Practice Address - Country:US
Practice Address - Phone:907-268-2067
Practice Address - Fax:855-395-0858
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7714207N00000X, 207NP0225X, 207NP0225X
OR157001207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1583538Medicaid
AK1583538Medicaid