Provider Demographics
NPI:1487721676
Name:BROWN, DEWITT C III (DR MD)
Entity type:Individual
Prefix:MR
First Name:DEWITT
Middle Name:C
Last Name:BROWN
Suffix:III
Gender:M
Credentials:DR MD
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Mailing Address - Street 1:52 CREST AVE
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152
Mailing Address - Country:US
Mailing Address - Phone:617-846-5366
Mailing Address - Fax:617-846-5460
Practice Address - Street 1:52 CREST AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152
Practice Address - Country:US
Practice Address - Phone:617-846-5366
Practice Address - Fax:617-846-5460
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA73370207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3076211Medicaid
MA073370OtherTUFTS
MAJ10506OtherBCBS OF MA
MAJ10506OtherBCBS OF MA
MA073370OtherTUFTS