Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 463 | SC |
N | 1223G0001X | General Practice | 3203 | SC |
N | 213EG0000X | General Practice | 3203 | SC |
NPI | 1083028617 |
---|---|
Provider Name | Dr. Melanie Anne Brown |
First Address | Isle Of Palms, SC 29451-2129 |
Second Address | Orangeburg, SC 29118-2126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2014 |
Last Update Date | 11/06/2014 |