Healthcare Provider Details

I. General information

NPI: 1245235910
Provider Name (Legal Business Name): BRUCE D BROWNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 ALLEN JARRETT DR
MEBANE NC
27302-9521
US

IV. Provider business mailing address

1603 ALLEN JARRETT DR
MEBANE NC
27302-9521
US

V. Phone/Fax

Practice location:
  • Phone: 919-563-2311
  • Fax: 919-563-2311
Mailing address:
  • Phone: 919-563-2311
  • Fax: 919-563-2311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number194475
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: