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NPI 1932291234

NPI 1932291234 : AMY L BROWN D.O. : DANIELS, WV

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General NPI Number Information
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    NPI Number           |    1932291234
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    Entity Type          |    Individual 
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    Provider Name        |    AMY L BROWN D.O.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/28/2006
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    Last Update Date     |    09/27/2012
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Provider Practice Location Address
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    Address Line         |    2157 RITTER DR 
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    City                 |    DANIELS
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    State                |    WV
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    Zip                  |    25832-9371
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    Country              |    US
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    Telephone            |    304-252-8551
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    Fax                  |    304-252-1790
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Provider Business Mailing Address
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    Address Line         |    252 RURAL ACRES DR 
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    City                 |    BECKLEY
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    State                |    WV
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    Zip                  |    25801-3503
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    Country              |    US
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    Telephone            |    304-252-8551
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    Fax                  |    304-252-1790
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    2048
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    License Number State |    WV
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