1891054896 NPI number — REBECCA FRANCES BROWN MD

Table of content: REBECCA FRANCES BROWN MD (NPI 1891054896)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891054896 NPI number — REBECCA FRANCES BROWN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
REBECCA
Provider Middle Name:
FRANCES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ASHTON
Provider Other First Name:
REBECCA
Provider Other Middle Name:
FRANCES
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1891054896
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
306 W REDWOOD ST FL 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21201-1708
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
667-214-1720
Provider Business Mailing Address Fax Number:
919-966-7841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
419 W REDWOOD ST STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201-7003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
667-214-1718
Provider Business Practice Location Address Fax Number:
410-328-5147
Provider Enumeration Date:
05/10/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  2015-01519 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086X0206X , with the licence number: D89422 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)