1962599647 NPI number — STEVEN T BROWER MD

Table of content: STEVEN T BROWER MD (NPI 1962599647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962599647 NPI number — STEVEN T BROWER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWER
Provider First Name:
STEVEN
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1962599647
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 95000-2424
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19195-2424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-420-4335
Provider Business Mailing Address Fax Number:
212-844-7696

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FIRST AVENUE AT 16TH STREET-DEPT OF SURGERY
Provider Second Line Business Practice Location Address:
BAIRD HALL, 16TH FLOOR, SUITE 20
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-420-4335
Provider Business Practice Location Address Fax Number:
212-844-7696
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  052521 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 27571 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086X0206X , with the licence number: 052521 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2086X0206X , with the licence number: 27571 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00432681 . This is a "RR MEDICARE ID UNDER OLD TIN 58-1611969" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: P00679477 . This is a "RR MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 02BBGKL . This is a "MEDICARE ID UNDER OLD TIN 58-1611969" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 115378530B , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00679513 . This is a "RR MEDICARE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: P00057010 . This is a "RR MEDICARE ID UNDER OLD TIN 58-1611969" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 01365958 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 115378530C , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: G52521 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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