Provider Demographics
NPI:1184680035
Name:MCHARNEY-BROWN, CARYN M (MD)
Entity Type:Individual
Prefix:DR
First Name:CARYN
Middle Name:M
Last Name:MCHARNEY-BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S CANAL ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5713
Mailing Address - Country:US
Mailing Address - Phone:575-628-1614
Mailing Address - Fax:575-234-0591
Practice Address - Street 1:407 W COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5209
Practice Address - Country:US
Practice Address - Phone:575-624-7533
Practice Address - Fax:575-624-7537
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM88-290207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM800521089OtherMEDICARE GROUP
NM30528Medicaid
NMP00946794OtherRRMCR
NM080192865OtherRAILROAD MEDICARE
NM1932187044OtherGROUP NPI
NM00NM009352OtherBCBS
NMNM300387Medicare PIN
NM800521089OtherMEDICARE GROUP
NME14193Medicare UPIN