Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 2923 | DC |
N | 1223P0106X | Oral and Maxillofacial Pathology | 4170 | VA |
N | 1223P0106X | Oral and Maxillofacial Pathology | 5621 | MD |
NPI | 1891908661 |
---|---|
Provider Name | Dr. Ronald Stephen Brown |
First Address | Arlington, VA 22207-3841 |
Second Address | Washington, DC 20015-2113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11689844 | CAQH PROVIDER NUMBER (01) | DC |
U59725 | (02) | DC |