Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 14620 | NC |
NPI | 1134265721 |
---|---|
Provider Name | Dr. Daniel Elmer Brown |
First Address | Raleigh, NC 27612-4759 |
Second Address | Raleigh, NC 27612-4759 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AB 3208279 | DEA NUMBER (01) | NC |