Provider Demographics
NPI:1750374302
Name:BROWN, ROBERT T (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:T
Last Name:BROWN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3901 INGERSOLL AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-3505
Mailing Address - Country:US
Mailing Address - Phone:515-274-9136
Mailing Address - Fax:515-274-3107
Practice Address - Street 1:3901 INGERSOLL AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-3505
Practice Address - Country:US
Practice Address - Phone:515-274-9136
Practice Address - Fax:515-274-3107
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-05-20
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Provider Licenses
StateLicense IDTaxonomies
IA17463207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA00990Medicare UPIN