MEDICARE: MICHAEL ABE BROWN M.D.

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	207X00000X	Orthopaedic Surgery Physician	MD00025370	WA
2	207X00000X	Orthopaedic Surgery Physician	G88678	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00336903	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0212264	OTHER	WA	LABOR & IND WA STATE

General Provider Information

NPI Number	:	1942286562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ABE BROWN M.D.

Provider Business Mailing Address
First Line	:	651 1ST ST W
Second Line	:	STE K
City	:	SONOMA
State	:	CA
Zip	:	95476-7045
Country	:	US
Telephone Number	:	707-938-3870
Fax Number	:	707-938-3076

Provider Business Practice Location Address
First Line	:	651 1ST ST W
Second Line	:	STE K
City	:	SONOMA
State	:	CA
Zip	:	95476-7045
Country	:	US
Telephone Number	:	707-938-3870
Fax Number	:	707-938-3076

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	02/25/2013

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