| Chad J Brown | |
|
4160 24th Ave S Ste 102 Fargo ND 58104-9038 | |
| (701) 941-0175 | |
| (701) 941-3001 |
| Full Name | Chad J Brown |
|---|---|
| Speciality | Clinic/Center |
| Location | 4160 24th Ave S, Fargo, North Dakota |
| Authorized Official Name and Position | Chad J Brown (OWNER) |
| Authorized Official Contact | 7019410175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chad J Brown 4160 24th Ave S Ste 102 Fargo ND 58104-9038 Ph: (701) 941-0175 | Chad J Brown 4160 24th Ave S Ste 102 Fargo ND 58104-9038 Ph: (701) 941-0175 |
| NPI Number | 1922693308 |
|---|---|
| Provider Enumeration Date | 03/07/2021 |
| Last Update Date | 05/29/2026 |
| Certification Date | 05/29/2026 |
| Medicare PECOS PAC ID | 9638575988 |
|---|---|
| Medicare Enrollment ID | O20210910002865 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922693308 | NPI | - | NPPES |
| 1482834 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Chad J Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710121116 PECOS PAC ID: 9032305149 Enrollment ID: I20101130001378 |
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