Provider Demographics
NPI:1215026570
Name:LESLIE-BROWN, HEATHER FAY MAUREEN (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:FAY MAUREEN
Last Name:LESLIE-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 1:1315 E SUNSET DR STE 203
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-4333
Mailing Address - Country:US
Mailing Address - Phone:704-288-4650
Mailing Address - Fax:704-225-3320
Practice Address - Street 1:1315 E SUNSET DR STE 203
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-4333
Practice Address - Country:US
Practice Address - Phone:704-288-4650
Practice Address - Fax:704-225-3320
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30190207V00000X
NC2005-01912207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG97442Medicare UPIN