Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 22552 | NC |
NPI | 1154543239 |
---|---|
Provider Name | Dr. Ronald L Brown |
First Address | Charlotte, NC 28211-2974 |
Second Address | Charlotte, NC 28211-2974 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C83001 | (02) | NC |