Healthcare Provider Details

I. General information

NPI: 1679507065
Provider Name (Legal Business Name): DAVID EUGENE BROWN III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 RICHLAND MEDICAL PARK DR STE 505
COLUMBIA SC
29203-6844
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-7950
  • Fax: 803-434-8606
Mailing address:
  • Phone: 864-522-8303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number22532
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: