Provider Demographics
NPI:1932375276
Name:BROWN, MICHELE SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:SUSAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 QUAKERBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1268
Mailing Address - Country:US
Mailing Address - Phone:609-689-1600
Mailing Address - Fax:
Practice Address - Street 1:2501 KUSER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-3386
Practice Address - Country:US
Practice Address - Phone:609-585-8800
Practice Address - Fax:609-585-1825
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1610022085R0202X
NJ25MA086350002085R0204X, 2085R0202X
DEC1-00098292085R0202X, 2085R0204X
PAMD4379032085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1932375276Medicaid
PA102366270Medicaid
NJ0207136Medicaid
DE1932375276Medicaid
NJ0207136Medicaid
DE230863Medicare PIN