Healthcare Provider Details

I. General information

NPI: 1558370940
Provider Name (Legal Business Name): DAVID A BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 11/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 GLESSNER AVE
MANSFIELD OH
44903-2269
US

IV. Provider business mailing address

5400 FRANTZ RD SUITE 250
DUBLIN OH
43016-4144
US

V. Phone/Fax

Practice location:
  • Phone: 419-522-0320
  • Fax:
Mailing address:
  • Phone: 614-544-6356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number35.064525
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: