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Individual

MR. PAUL ROBERT BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA C

Contact information

Practice address
2222 CHERRY ST, MOB 2 - STE 1250 C/O MERCY CARDIOTHORACIC SURGICAL, TOLEDO, OH 43608-2673
(419) 251-3180
(419) 251-3849
Mailing address
449 MOCKINGBIRD CT, LINDENHURST, IL 60046-4933
(847) 316-6844

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085000868
IL
363AS0400X
Surgical Physician Assistant
50001371
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50-001371
MEDICAL LICENSE
OH
Enumeration date
12/28/2007
Last updated
05/03/2012
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