Provider Demographics
NPI:1194882928
Name:BROWN, MICHAEL HOWARD (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HOWARD
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 COOKSON AVE SE
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-9569
Mailing Address - Country:US
Mailing Address - Phone:330-339-6693
Mailing Address - Fax:330-365-1398
Practice Address - Street 1:802 COOKSON AVE SE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-9569
Practice Address - Country:US
Practice Address - Phone:330-339-6693
Practice Address - Fax:330-365-1398
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1107111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1331801OtherUNITED HEALTH MINER
OH34-1477562OtherFEDERAL TAX ID#
OH350008579OtherUNITED HEALTH RAILROAD
OH2273641Medicaid
OH34-147756200OtherWORKER'S COMPENSATION