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NPI 1508962093

NPI 1508962093 : ERIC YALE BROWN M.D. : ALBUQUERQUE, NM

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General NPI Number Information
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    NPI Number           |    1508962093
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    Entity Type          |    Individual 
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    Provider Name        |    ERIC YALE BROWN M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/15/2006
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    Last Update Date     |    10/28/2021
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Provider Practice Location Address
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    Address Line         |    3821 MASTHEAD ST NE 
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    City                 |    ALBUQUERQUE
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    State                |    NM
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    Zip                  |    87109-4679
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    Country              |    US
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    Telephone            |    505-998-7400
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    Fax                  |    505-998-7741
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Provider Business Mailing Address
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    Address Line         |    3821 MASTHEAD ST NE 
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    City                 |    ALBUQUERQUE
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    State                |    NM
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    Zip                  |    87109-4679
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    Country              |    US
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    Telephone            |    505-998-7400
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    Fax                  |    505-998-7741
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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        |    207RN0300X
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    Taxonomy Name        |    Nephrology Physician
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    License Number       |    029215
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    License Number State |    CT
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Taxonomy #2
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    Taxonomy Code        |    207RN0300X
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    Taxonomy Name        |    Nephrology Physician
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    License Number       |    MD2021-0795
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    License Number State |    NM
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