Individual
MEIUTTENUN CHONG MARIE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8200 OLD 13 MILE RD, SUITE 106, WARREN, MI 48093-2171
(586) 558-6990
(586) 558-6996
Mailing address
8200 OLD 13 MILE RD, SUITE 106, WARREN, MI 48093-2171
(586) 558-6990
(586) 558-6996
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
4301088766
MI
208D00000X
General Practice Physician
Primary
4301088766
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104918871
—
MI
05
—
104918880
—
MI
05
—
104918890
—
MI
05
—
104918906
—
MI
05
—
104918915
—
MI
01
—
700H248710
BLUE CROSS GROUP NUMBER
MI
Enumeration date
08/04/2006
Last updated
09/30/2013
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