MEDICARE: MATTHEW 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	163WC0200X	Critical Care Medicine Registered Nurse	RN335463	GA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	163WC0200X	Critical Care Medicine Registered Nurse	819385	NY
4	163WC0200X	Critical Care Medicine Registered Nurse	RN-130277	HI

General Provider Information

NPI Number	:	1871487165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW BROWN

Provider Business Mailing Address
First Line	:	119 KENNINGHALL CT SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-3891
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 KENNINGHALL CT SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-3891
Country	:	US
Telephone Number	:	646-812-4838
Fax Number	:

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

Provider Enumeration Date	:	06/03/2025
Last Update Date	:	06/20/2026

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Directions to “ MATTHEW BROWN ” Practice Location

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