Provider Demographics
NPI:1952392888
Name:BROWN, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
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:PO BOX 9135
Mailing Address - Street 2:ATT:SHARON SILVA
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-9135
Mailing Address - Country:US
Mailing Address - Phone:603-893-9784
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-7893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1599582080P0202X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDB51503Medicaid
MAJ26408OtherHMO BLUE
AL9938705Medicaid
MAAA9208OtherHARVARD PILGRIM
CT003122504Medicaid
MA3253340OtherAETNA MA
MA26527OtherBMC HEALTHNET
MA2010364Medicaid
MA97288101OtherNETWORK HEALTH
NH30204038Medicaid
MAJ26408OtherBLUE CARE ELECT
MAJ26408OtherBCBS MA
MAP00031693OtherRAILROAD MEDICARE
MA32294OtherNEIGHBORHOOD HEALTH PLAN
MA159958OtherTUFTS HEALTH PLAN
NY2490504Medicaid
MAA35455Medicare ID - Type Unspecified
AL9938705Medicaid