Provider Demographics
NPI:1306846613
Name:BROWN, LEAH C (MD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:C
Last Name: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 1:4601 PARK RD
Mailing Address - Street 2:STE 250
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3239
Mailing Address - Country:US
Mailing Address - Phone:704-323-2000
Mailing Address - Fax:
Practice Address - Street 1:13402 N SCOTTSDALE RD STE A125
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4055
Practice Address - Country:US
Practice Address - Phone:480-531-6007
Practice Address - Fax:602-429-8336
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108854207X00000X
WA60286925207X00000X
NC2014-01837207X00000X
AZ52104207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNC2400Medicaid
SCNC2400Medicaid