Individual
MANUEL L. BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301035229
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
430630310
—
MI
01
—
700H262300
BLUE CROSS-BLUE CROSS
—
01
—
MB035229
CHAMPUS-CHAMPUS
—
Enumeration date
12/01/2006
Last updated
03/03/2021
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