Physician Compare National (NPI:1336239664)

HEALTHCARE PROVIDER: CHARLES MICHAEL BROWN M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1336239664
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567565922
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071030000411
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BROWN
	Individual professional last name
Provider First Name	CHARLES
	Individual professional first name
Provider Middle Name	MICHAEL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	INTERVENTIONAL CARDIOLOGY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE, INTERVENTIONAL CARDIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	CENTERVILLE CLINICS INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7214837202
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	50
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1070 OLD NATIONAL PIKE
	Group Practice or individual's line 1 address
Line 2 Street Address	CARDIOLOGY
	Group Practice or individual's line 2 address
City	FREDERICKTOWN
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	153332114
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7246326801
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390265
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JEFFERSON HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y