# BROWN MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104564137
- **Authorized official:** DONNA GORDON (RCM DIRECTOR)
- **Authorized official phone:** (401) 443-5107

## Contact information

- **Practice address:** 375 WAMPANOAG TRL, RIVERSIDE, RI 02915-2232
- **Practice address phone:** (401) 444-7793
- **Mailing address:** DEPT 3010, PO BOX 986524, BOSTON, MA 02298-6524
- **Mailing address phone:** (401) 443-4992
- **Mailing address fax:** (401) 537-7241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | — |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |
| 207RI0200X | Infectious Disease Physician | — | NULL | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |
| 207RR0500X | Rheumatology Physician | — | NULL | — |
| 207RR0500X | Rheumatology Physician | — | — | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | — | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/20/2022
- **Last updated:** 02/14/2024