MEDICARE: SHAUN BROWNLEE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	043009	GA

General Provider Information

NPI Number	:	1417072851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUN BROWNLEE M.D.

Provider Business Mailing Address
First Line	:	559 HIGHLAND PARK AVE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-1351
Country	:	US
Telephone Number	:	404-577-9497
Fax Number	:

Provider Business Practice Location Address
First Line	:	4223 MORELAND AVE
Second Line	:
City	:	CONLEY
State	:	GA
Zip	:	30288-2141
Country	:	US
Telephone Number	:	404-366-2900
Fax Number	:	404-366-2994

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	09/02/2009

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