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Individual

INGRID M BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2510 COMMONS BLVD, SUITE 210, BEAVERCREEK, OH 45431-3820
(937) 429-0607
(937) 558-3067
Mailing address
2510 COMMONS BLVD, SUITE 210, BEAVERCREEK, OH 45431-3820
(937) 429-0607
(937) 558-3067

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34006519B
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000066109
ANTHEM
OH
01
110195587
RR MEDICARE
OH
05
2032133
OH
01
2176908
AETNA
OH
01
311346460032
CARESOURCE
OH
Enumeration date
07/14/2005
Last updated
06/18/2014
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