Provider Demographics
NPI:1841344231
Name:BROWN, GREG L (MD)
Entity type:Individual
Prefix:DR
First Name:GREG
Middle Name:L
Last Name:BROWN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2607 N. GRANDVIEW BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188
Mailing Address - Country:US
Mailing Address - Phone:262-522-8640
Mailing Address - Fax:262-522-8649
Practice Address - Street 1:2607 N. GRANDVIEW BLVD
Practice Address - Street 2:STE 150
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188
Practice Address - Country:US
Practice Address - Phone:262-522-8640
Practice Address - Fax:262-522-8649
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2013-11-18
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Provider Licenses
StateLicense IDTaxonomies
WI26924020207R00000X
WIWI-26924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B51773Medicare UPIN
351773Medicare UPIN