Provider Demographics
NPI:1972530129
Name:BROWN, DAVID MITCHELL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MITCHELL
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE STREET SE, MMC 404
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-0622
Mailing Address - Fax:612-626-2696
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:420 DELAWARE STREET SE, ROOM 760 MAYO MEMORIAL BUILDING
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-0622
Practice Address - Fax:612-626-2696
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN16787207ZP0104X, 208000000X, 2080P0205X, 2080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Not Answered2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0500694Medicaid
MN33-00031OtherMEDICA PRIMARY
MN1008996OtherPREFERRED ONE
MN33-00262OtherMEDICA CHOICE
MNB709OtherCHAMPUS
MN2T268BROtherBCBS
WI31265300Medicaid
MNHP28822OtherHEALTHPARTNERS
MN1008996OtherPREFERRED ONE