1679557391 NPI number — MELISSA R BROWN M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679557391 NPI number — MELISSA R BROWN M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

BROWN

Provider First Name:

MELISSA

Provider Middle Name:

R

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1679557391

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/07/2013

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 5074

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SIOUX FALLS

Provider Business Mailing Address State Name:

SD

Provider Business Mailing Address Postal Code:

57117-5074

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

3015 3RD AVE SE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

ABERDEEN

Provider Business Practice Location Address State Name:

SD

Provider Business Practice Location Address Postal Code:

57401-5418

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

605-725-1700

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

12/06/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208800000X , with the licence number:  46530 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208800000X , with the licence number: 8970 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: HP42662 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 707660600 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
• Identifier: 485T9BR . This is a "BCBS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: MH9041041406 . This is a "PPO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 2145446 . This is a "ARAZ" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 485T9BR , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
• Identifier: 9941 . This is a "AVERA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 19-00587 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 485T9BR . This is a "BCBS/MEDICARE SUPPLEMENT" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 478575 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
• Identifier: 131939 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".