MEDICARE: DR. PAUL SHERMAN BROWN JR. MD

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	208600000X	Surgery Physician	0101265546	VA
2	2086S0129X	Vascular Surgery Physician	0101265546	VA
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	21945	ND
4	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	0101265546	VA

General Provider Information

NPI Number	:	1841294824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL SHERMAN BROWN JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 5074
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57117-5074
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2205 MCCABES GRANT CT
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23233-8713
Country	:	US
Telephone Number	:	804-709-6808
Fax Number	:	804-681-0445

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	02/17/2025

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