Healthcare Provider Details

I. General information

NPI: 1770088932
Provider Name (Legal Business Name): DONALD TRACY BROWNE III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2304 WESVILL CT STE 360
RALEIGH NC
27607-2981
US

IV. Provider business mailing address

2304 WESVILL CT STE 360
RALEIGH NC
27607-2981
US

V. Phone/Fax

Practice location:
  • Phone: 919-785-1220
  • Fax:
Mailing address:
  • Phone: 919-785-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number100243
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number237993
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: