Healthcare Provider Details

I. General information

NPI: 1457565806
Provider Name (Legal Business Name): BRENT A. TOWNSEND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 BROWNING PL
RALEIGH NC
27609-6536
US

IV. Provider business mailing address

3949 BROWNING PL
RALEIGH NC
27609-6536
US

V. Phone/Fax

Practice location:
  • Phone: 919-787-8221
  • Fax: 919-789-4461
Mailing address:
  • Phone: 919-787-8221
  • Fax: 919-789-4461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number111025
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number2009-00679
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: