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NPI Code Detail

MEDICARE: MR. MAURICE ANTONIO BROWN

MEDICARE: MR. MAURICE ANTONIO BROWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianNC

General Provider Information

NPI Number : 1750982641
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MAURICE ANTONIO BROWN
Provider Business Mailing Address
First Line : 418B W MOUNTAIN ST
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27284-2534
Country : US
Telephone Number : 704-780-4271
Fax Number :
Provider Business Practice Location Address
First Line : 770 PARK CENTRE DR
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27284-3598
Country : US
Telephone Number : 704-780-4271
Fax Number : 704-788-2016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2020
Last Update Date : 11/05/2020

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Directions to “ MR. MAURICE ANTONIO BROWN ” Practice Location

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