Provider Demographics
NPI:1033234455
Name:BROWN, DEBRA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:31 LYNN LN
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-9531
Mailing Address - Country:US
Mailing Address - Phone:187-753-0988
Mailing Address - Fax:304-744-2096
Practice Address - Street 1:LABORATORY CORPORATION OF AMERICA
Practice Address - Street 2:312 6TH AVE
Practice Address - City:S. CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303
Practice Address - Country:US
Practice Address - Phone:304-744-7017
Practice Address - Fax:304-744-2096
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV22545207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology