Healthcare Provider Details

I. General information

NPI: 1851595482
Provider Name (Legal Business Name): STEVEN MARSHALL BROWN CEAP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 05/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 W PEACHTREE ST NW
ATLANTA GA
30309-3608
US

IV. Provider business mailing address

66 SLOAN ST
ROSWELL GA
30075-4946
US

V. Phone/Fax

Practice location:
  • Phone: 404-853-2850
  • Fax:
Mailing address:
  • Phone: 404-502-3991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number34595
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: