Basic Information
| Provider Information | |||||||||
| NPI: | 1679500995 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| Address2: | 420 DELAWARE STREET SE, MMC 493 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126254400 | ||||||||
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| Practice Location | |||||||||
| Address1: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| Address2: | 516 DELAWARE STREET SE, PWB NINTH FLOOR, CLINIC 9A | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126254400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 20850 | MN | X | Allopathic & Osteopathic Physicians | Internal Medicine | 207W00000X | 20850 | MN | X | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 0134002 | 01 | MN | PREFERRED ONE | OTHER | 08-00961 | 01 | MN | MEDICA CHOICE | OTHER | 08-00043 | 01 | MN | MEDICA PRIMARY | OTHER | 101316 | 01 | MN | UCARE | OTHER | B58467 | 01 | MN | UPIN | OTHER | HP10177 | 01 | MN | HEALTHPARTNERS | OTHER | 763557 | 01 | MN | ARAZ | OTHER |