Provider Demographics
NPI:1053310276
Name:BROWN, GREGORY P (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:P
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 MEDICAL PARK LOOP STE 503
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-4110
Mailing Address - Country:US
Mailing Address - Phone:828-586-7994
Mailing Address - Fax:828-586-7340
Practice Address - Street 1:186 MEDICAL PARK LOOP STE 503
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-4110
Practice Address - Country:US
Practice Address - Phone:828-586-7994
Practice Address - Fax:828-586-7340
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4113351OtherAETNA NON HMO
PAP01071926OtherRAILROAD MEDICARE
PA867633OtherMEDICARE GROUP #
060040411OtherMEDICARE RAILROAD PIN
PA8515060OtherAETNA HMO
PA0012863410002Medicaid
PA060492LN7Medicare PIN
PAP01071926OtherRAILROAD MEDICARE
PAA02554Medicare UPIN