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General NPI Number Information
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NPI Number | 1225357627
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Entity Type | Individual
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Provider Name | JEFFREY DAVID BROWN D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 2500 METROHEALTH DR
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City | CLEVELAND
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State | OH
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Zip | 44109-1900
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Country | US
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Telephone | 216-778-5904
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Fax |
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Provider Business Mailing Address
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Address Line | 17713 FERNWAY RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44122-3427
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | STUDENT
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License Number State | ME
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