Provider Demographics
NPI:1770595688
Name:BROWN, NEIL G (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:G
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4536 BONNEY RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3869
Mailing Address - Country:US
Mailing Address - Phone:757-490-9388
Mailing Address - Fax:757-490-9401
Practice Address - Street 1:736 BATTLEFIELD BLVD N
Practice Address - Street 2:CHESAPEAKE GENERAL HOSPITAL
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4941
Practice Address - Country:US
Practice Address - Phone:757-490-9388
Practice Address - Fax:757-490-9401
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2017-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101224731207PE0004X
IN01064276A207P00000X
MA268745207P00000X
MO2016011278207P00000X
NMMD2015-0400207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110118587AMedicaid
930091447OtherMEDICARE RAILROAD
063UAOtherBLUE CROSS BLUE SHIELD NC
VA5841275Medicaid
082480OtherBLUE CROSS BLUE SHIELD VA
251490OtherMAMSI
3900570OtherOPTIMUM CHOICE
NC89063UAMedicaid
IN000000529965OtherANTHEM
27946OtherOPTIMA
IN200875270Medicaid
VA5841275Medicaid
INP00431376Medicare PIN
063UAOtherBLUE CROSS BLUE SHIELD NC
3900570OtherOPTIMUM CHOICE
NC89063UAMedicaid