Healthcare Provider Details

I. General information

NPI: 1528128345
Provider Name (Legal Business Name): FELICIA NICHOLSONBROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FELICIA NICHOLSON MD

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9175 GUILFORD RD STE 300-1020
COLUMBIA MD
21046-1849
US

IV. Provider business mailing address

PO BOX 82
GLENELG MD
21737-0082
US

V. Phone/Fax

Practice location:
  • Phone: 410-512-9122
  • Fax:
Mailing address:
  • Phone: 410-512-9122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0062626
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: