Brown, Wendy Thomas
Brown, Wendy Thomas is an individual health care provider with primary practice located at 3264 N Evergreen Dr Ne , Grand Rapids MI 49525-9746. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Pediatric Radiology is her primary health care specialty. Brown, Wendy Thomas can be contacted via phone (616) 363-7272.Contact Information
Primary practice address
3264 N Evergreen Dr Ne
Grand Rapids MI 49525-9746
Phone: (616) 363-7272
Fax: (616) 361-5828
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | 0101052989 | Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 4301501891 | Michigan |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 0101052989 | Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 40286 | Tennessee |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | 4301501891 | Michigan |
Profile Details
| NPI number | 1053398412 |
|---|---|
| LBN Legal business name | Brown, Wendy Thomas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2005 |
| Last updated | Jul 29th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053398412 | NPPES |
| Virginia | Other | 10110018 | OPTIMA HEALTH PLAN |
| Virginia | Other | 10110018 | OPTIMA HEALTH PLAN |
| Virginia | Other | 180AF | OPTIMA HEALTH PLAN |
| Virginia | Other | 1053398412 | OPTIMA HEALTH PLAN |
| Virginia | MEDICAID | 1053398412 | OPTIMA HEALTH PLAN |
| Virginia | MEDICAID | 1053398412 | OPTIMA HEALTH PLAN |
| Virginia | Other | 1053398412 | OPTIMA HEALTH PLAN |
| Virginia | Other | P01206178 | OPTIMA HEALTH PLAN |
| Virginia | Other | 139178 | OPTIMA HEALTH PLAN |
| Virginia | Other | 5512875 | OPTIMA HEALTH PLAN |
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