Healthcare Provider Details

I. General information

NPI: 1033260633
Provider Name (Legal Business Name): DAVID RICHARD BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 SAINT MICHAELS DR STE B104
SANTA FE NM
87505-7671
US

IV. Provider business mailing address

88 RAVENS RIDGE RD
SANTA FE NM
87505-8139
US

V. Phone/Fax

Practice location:
  • Phone: 505-820-9945
  • Fax: 505-399-3116
Mailing address:
  • Phone: 505-989-8635
  • Fax: 844-218-9645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number87-210
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number87-210
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: