Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 01026507 | IN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 01026507 | IN |
NPI | 1376622936 |
---|---|
Provider Name | Dr. Lorin Merrill Brown |
First Address | Munster, IN 46321-3962 |
Second Address | Munster, IN 46321-3958 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 08/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000089919 | ANTHEM (01) | IN |
100168000A | (05) | IN |
649510 | (05) | IL |
90000075 | BCBS IL (01) | IL |
C25254 | (02) |