Provider Demographics
NPI:1538148515
Name:BROWN, ERIC A (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:29992 NORTHWESTERN HWY STE C
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3292
Mailing Address - Country:US
Mailing Address - Phone:248-687-7300
Mailing Address - Fax:248-687-7305
Practice Address - Street 1:4967 CROOKS RD STE 210
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-5804
Practice Address - Country:US
Practice Address - Phone:248-687-7300
Practice Address - Fax:248-687-7305
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301054754208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3052118Medicaid
ON30540Medicare ID - Type Unspecified
F78388Medicare UPIN
MI3052118Medicaid