Healthcare Provider Details

I. General information

NPI: 1124133657
Provider Name (Legal Business Name): DANIEL EDWARD BROWN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 ESSEX CENTER DR SUITE 208 - PEABODY PODIATRY
PEABODY MA
01960-2904
US

IV. Provider business mailing address

19 DESMOND AVE APARTMENT E
MANCHESTER MA
01944-1355
US

V. Phone/Fax

Practice location:
  • Phone: 978-531-9969
  • Fax: 978-531-3745
Mailing address:
  • Phone: 774-239-4534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2215
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: