MEDICARE: SHAWN BROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency	S21149257	MA

General Provider Information

NPI Number	:	1528458213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN BROWN

Provider Business Mailing Address
First Line	:	41 GRANT AVE
Second Line	:
City	:	BROCKTON
State	:	MA
Zip	:	02301-6935
Country	:	US
Telephone Number	:	617-212-1197
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 GOULD ST
Second Line	:	SUITE 300
City	:	NEEDHAM
State	:	MA
Zip	:	02494-2313
Country	:	US
Telephone Number	:	617-519-0959
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2015
Last Update Date	:	02/02/2015

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Directions to “ SHAWN BROWN ” Practice Location

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