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NPI Code Detail

MEDICARE: DR. ANDREA GRACE BROWN DO

MEDICARE: DR. ANDREA GRACE BROWN DO
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
1207Q00000XFamily Medicine Physician2022033110MO

General Provider Information

NPI Number : 1548897499
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA GRACE BROWN DO
Provider Business Mailing Address
First Line : 3721 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63118-3405
Country : US
Telephone Number : 314-328-0144
Fax Number : 314-788-3021
Provider Business Practice Location Address
First Line : 3721 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63118-3405
Country : US
Telephone Number : 314-328-0144
Fax Number : 314-788-3021
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2020
Last Update Date : 06/27/2023

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