Healthcare Provider Details

I. General information

NPI: 1518073485
Provider Name (Legal Business Name): BRUCE CHARLES DENNY-BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 MAIN ST
ELLSWORTH ME
04605-3901
US

IV. Provider business mailing address

405 MAIN ST
ELLSWORTH ME
04605-3901
US

V. Phone/Fax

Practice location:
  • Phone: 207-667-5955
  • Fax: 207-667-7002
Mailing address:
  • Phone: 207-667-5955
  • Fax: 207-667-7002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number7846
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: