Healthcare Provider Details

I. General information

NPI: 1750657755
Provider Name (Legal Business Name): NATHANIEL JOSEPH BROWN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2012
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SAINT MICHAELS DR
SANTA FE NM
87505-7601
US

IV. Provider business mailing address

1700 N WHEELING ST ROCKY MOUNTAIN REGIONAL VAMC -- ANESTHESIOLOGY
AURORA CO
80045
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-3065
  • Fax:
Mailing address:
  • Phone: 303-399-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number18057
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD2025-1115
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDR0057098
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: