Healthcare Provider Details

I. General information

NPI: 1659355162
Provider Name (Legal Business Name): DOUGLAS GUY BROWNING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 E MEADOW RD
EDEN NC
27288-3468
US

IV. Provider business mailing address

161 HUNTERS RIDGE RD
WINSTON SALEM NC
27103-5262
US

V. Phone/Fax

Practice location:
  • Phone: 336-864-2795
  • Fax: 336-864-2895
Mailing address:
  • Phone: 336-277-2435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33794
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number33794
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: