Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 033654 | CT |
Y | 208200000X | Surgeon | 033654 | CT |
Y | 208600000X | Surgeon | 033654 | CT |
NPI | 1457350696 |
---|---|
Provider Name | Matthew George Brown |
First Address | Hartford, CT 06106-5501 |
Second Address | Hartford, CT 06106-5501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 07/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001336545 | (05) | CT |
E66594 | (02) | CT |