Provider Demographics
NPI:1770059529
Name:BROWN, ZACHARY KENNETH (EMT-B)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:KENNETH
Last Name:BROWN
Suffix:
Gender:M
Credentials:EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 S CRAPO ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3662
Mailing Address - Country:US
Mailing Address - Phone:989-330-1827
Mailing Address - Fax:
Practice Address - Street 1:906 S CRAPO ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-3662
Practice Address - Country:US
Practice Address - Phone:989-330-1827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIE3411973207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services