Healthcare Provider Details

I. General information

NPI: 1447013552
Provider Name (Legal Business Name): ALEXIS C BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 SAINT MATTHEWS RD
ORANGEBURG SC
29118-1442
US

IV. Provider business mailing address

PO BOX 18
NEESES SC
29107-0018
US

V. Phone/Fax

Practice location:
  • Phone: 803-533-2200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: