Individual
MICHAEL BROUSE FALLON
Active
Individual
MICHAEL BROUSE FALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
18655
AL
207RG0100X
Gastroenterology Physician
Primary
N1316
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000025081
—
AL
05
—
0122311
—
MS
01
—
051025081
BLUE CROSS
AL
05
—
198331401
—
TX
01
—
8F6668
BCBS
TX
Enumeration date
10/04/2006
Last updated
01/18/2011
Update your record
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