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General NPI Number Information
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NPI Number | 1114928900
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Entity Type | Individual
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Provider Name | BERT M. BROWN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 6770 MAYFIELD ROAD SUITE 210
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City | MAYFIELD HTS
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State | OH
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Zip | 44124
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Country | US
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Telephone | 440-461-0150
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Fax | 440-461-8221
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Provider Business Mailing Address
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Address Line | 6770 MAYFIELD RD SUITE 210
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-2299
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Country | US
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Telephone | 440-461-0150
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Fax | 440-461-8221
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 35-05-6634
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License Number State | OH
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