Healthcare Provider Details

I. General information

NPI: 1831170109
Provider Name (Legal Business Name): TODD B BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 01/26/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 THOMAS PL
WEST END NC
27376-8350
US

IV. Provider business mailing address

188 THOMAS PL
WEST END NC
27376-8350
US

V. Phone/Fax

Practice location:
  • Phone: 910-705-5213
  • Fax:
Mailing address:
  • Phone: 910-705-5213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number00026140
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2009-00061
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: