Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | P17503 | MD |
NPI | 1053456566 |
---|---|
Provider Name | Dr. Kisha Perkins Brown |
First Address | Upper Marlboro, MD 20772-5374 |
Second Address | Upper Marlboro, MD 20772-5374 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 08/09/2014 |