Healthcare Provider Details
I. General information
NPI: 1871339911
Provider Name (Legal Business Name): BROWN, CROFT, FRAZIER, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2024
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8118 GOOD LUCK RD
LANHAM MD
20706-3574
US
IV. Provider business mailing address
2002 MEDICAL PKWY STE 235
ANNAPOLIS MD
21401-3260
US
V. Phone/Fax
- Phone: 301-552-8118
- Fax:
- Phone: 410-266-2770
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085D0003X |
| Taxonomy | Diagnostic Neuroimaging (Radiology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
F
TODD
Title or Position: PRESIDENT
Credential: MD, MHA
Phone: 410-266-2770