Provider Demographics
NPI:1376658583
Name:BROWN, NOEL (MD)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:
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 1:2421 SILVER STREAM LANE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-0000
Mailing Address - Country:US
Mailing Address - Phone:910-395-3477
Mailing Address - Fax:910-815-3479
Practice Address - Street 1:2421 SILVER STREAM LANE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-0000
Practice Address - Country:US
Practice Address - Phone:910-395-3477
Practice Address - Fax:910-815-3479
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22551207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8919145Medicaid
NCP00052969OtherRAILROAD MEDICARE
NC19145OtherBCBS NC
NCP00052969OtherRAILROAD MEDICARE
NCC81004Medicare UPIN