Healthcare Provider Details

I. General information

NPI: 1770595688
Provider Name (Legal Business Name): NEIL G. BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 BATTLEFIELD BLVD N CHESAPEAKE GENERAL HOSPITAL
CHESAPEAKE VA
23320-4941
US

IV. Provider business mailing address

4536 BONNEY RD
VIRGINIA BEACH VA
23462-3869
US

V. Phone/Fax

Practice location:
  • Phone: 757-490-9388
  • Fax: 757-490-9401
Mailing address:
  • Phone: 757-490-9388
  • Fax: 757-490-9401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number0101224731
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01064276A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number268745
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2016011278
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD2015-0400
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: