MEDICARE: EDWARD EMERICK BROWNE-MARKE

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
1	172A00000X	Driver	8904459	NC

General Provider Information

NPI Number	:	1982248746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD EMERICK BROWNE-MARKE

Provider Business Mailing Address
First Line	:	2 CENTERVIEW DR STE 27
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-3708
Country	:	US
Telephone Number	:	336-451-7763
Fax Number	:	336-517-0828

Provider Business Practice Location Address
First Line	:	2 CENTERVIEW DR STE 27
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-3708
Country	:	US
Telephone Number	:	336-451-7763
Fax Number	:	336-517-0828

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2019
Last Update Date	:	11/04/2019

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