Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 042-0011186 | VT |
N | 207V00000X | Obstetrician & Gynecologist | 042-0011186 | VT |
NPI | 1093729576 |
---|---|
Provider Name | Stephen A. Brown |
First Address | South Burlington, VT 05403-7713 |
Second Address | Burlington, VT 05401-1473 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C08216 | (02) | VT |