Provider Demographics
NPI:1811953839
Name:BROWN, MALCOLM D (MD)
Entity type:Individual
Prefix:
First Name:MALCOLM
Middle Name:D
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4212 CARMICHAEL CT N
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3621
Mailing Address - Country:US
Mailing Address - Phone:334-213-8804
Mailing Address - Fax:334-213-8815
Practice Address - Street 1:4212 CARMICHAEL CT N
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3621
Practice Address - Country:US
Practice Address - Phone:334-213-8804
Practice Address - Fax:334-213-8815
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00006825208D00000X
ALMD.6825207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009934697Medicaid
AL051051317OtherBLUE CROSS