Provider Demographics
NPI:1114582889
Name:BROWN, ZACHARY CARLTON (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:CARLTON
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 1:3208 S CHESTERFIELD CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-5767
Mailing Address - Country:US
Mailing Address - Phone:859-421-3295
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:859-421-3295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2024-01-25
Deactivation Date:2021-03-24
Deactivation Code:
Reactivation Date:2021-06-10
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA1114582889207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program