Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 47413 | CO |
Y | 207ND0101X | MOHS-Micrographic Surgeon | DR.0047413 | CO |
NPI | 1154468445 |
---|---|
Provider Name | Mariah Brown |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 06/10/2020 |