Healthcare Provider Details

I. General information

NPI: 1932321155
Provider Name (Legal Business Name): MICHAEL BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 HOSPITAL PARK
MOULTRIE GA
31768-6772
US

IV. Provider business mailing address

PO BOX 2876
MOULTRIE GA
31776-2876
US

V. Phone/Fax

Practice location:
  • Phone: 229-985-4469
  • Fax:
Mailing address:
  • Phone: 229-985-4469
  • Fax: 229-891-3526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD28509
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number067394
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: