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Individual

DR. ANGELIQUE D BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6111 HARRISON ST, SUITE 331, MERRILLVILLE, IN 46410-2969
(219) 887-1340
(219) 887-1518
Mailing address
8777 BROADWAY, SUITE 331, MERRILLVILLE, IN 46410-6693
(219) 738-3854
(219) 738-3864

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045570A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01045570A
PHYSICIAN'S LICENSE #
IN
01
01045570B
CONTROLLED SUBSTANCE #
IN
01
15D0938335
CLIA #
IN
05
200098750B
IN
01
207Q0000X
TAXONOMY CODE
IN
Enumeration date
01/26/2006
Last updated
03/07/2023
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