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General NPI Number Information
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NPI Number | 1679611909
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Entity Type | Individual
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Provider Name | NILS M. BROWNWORTH P.A.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 20412 SUNBRIGHT LN
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City | GERMANTOWN
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State | MD
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Zip | 20874-1087
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Country | US
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Telephone | 301-972-0400
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Fax | 301-916-1453
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Provider Business Mailing Address
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Address Line | 19851 OBSERVATION DR STE 250
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City | GERMANTOWN
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State | MD
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Zip | 20876-4139
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Country | US
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Telephone | 301-972-0400
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Fax | 301-916-1453
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0002533
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License Number State | MD
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