Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 19757 | SC |
NPI | 1407802267 |
---|---|
Provider Name | Daniel Craig Brown |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203-6844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 23/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F57408 | (02) | SC |
T38689 | (05) | SC |