Healthcare Provider Details

I. General information

NPI: 1760121776
Provider Name (Legal Business Name): ANDREW CORBIN BROWN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GENESYS PKWY
GRAND BLANC MI
48439-8065
US

IV. Provider business mailing address

5921 ALTON CT
ELDERSBURG MD
21784-6981
US

V. Phone/Fax

Practice location:
  • Phone: 810-606-6954
  • Fax:
Mailing address:
  • Phone: 443-539-6438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5951001446
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number5901400572
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: