Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 87-210 | NM |
NPI | 1033260633 |
---|---|
Provider Name | Dr. David Richard Brown |
First Address | Santa Fe, NM 87505-8139 |
Second Address | Santa Fe, NM 87505-7671 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 08/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
39156 | (05) | NM |
87-210 | STATE LICENSURE NUMBER (01) | NM |
D43057 | (02) | NM |