Provider Demographics
NPI:1902885247
Name:BROWN, VINCENT C (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:C
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1301 PUNCHBOWL ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2402
Mailing Address - Country:US
Mailing Address - Phone:808-547-4771
Mailing Address - Fax:808-547-4507
Practice Address - Street 1:2226 LILIHA ST STE B2
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1605
Practice Address - Country:US
Practice Address - Phone:808-547-6881
Practice Address - Fax:808-744-6958
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI25082085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04042407Medicaid
HIF44500OtherHMSA #
HIE47120Medicare UPIN
HIH56638Medicare PIN