Provider Demographics
NPI:1386640365
Name:BROWN, SAMUEL ISAAC (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ISAAC
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 1:501 DISCOVERY DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3843
Mailing Address - Country:US
Mailing Address - Phone:757-547-5145
Mailing Address - Fax:757-312-0216
Practice Address - Street 1:501 DISCOVERY DR.
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-547-5145
Practice Address - Fax:757-436-2480
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043502207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006422209Medicaid
VA006422209Medicaid
VA200000389Medicare ID - Type Unspecified