Provider Demographics
NPI:1376679043
Name:BROWN, BROOKS GIDEON III (MD)
Entity type:Individual
Prefix:
First Name:BROOKS
Middle Name:GIDEON
Last Name:BROWN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2661 RIVA RD STE 1030
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7131
Mailing Address - Country:US
Mailing Address - Phone:410-571-8733
Mailing Address - Fax:410-571-6309
Practice Address - Street 1:5454 WISCONSIN AVE STE 1420
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6961
Practice Address - Country:US
Practice Address - Phone:301-654-0767
Practice Address - Fax:301-654-0769
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0015744207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD005411900Medicaid
MD005411900Medicaid
D18104Medicare UPIN