Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 20412 | GA |
NPI | 1033161427 |
---|---|
Provider Name | Mr. Morris E. Brown |
First Address | Atlanta, GA 30328-6773 |
Second Address | Atlanta, GA 30309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 06/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D12054 | (02) | GA |