Provider Demographics
NPI:1467638502
Name:BROWN, DOUGLAS H (PA-C)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:H
Last Name:BROWN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701
Mailing Address - Country:US
Mailing Address - Phone:240-397-6723
Mailing Address - Fax:833-992-0865
Practice Address - Street 1:723 N MARKET ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5232
Practice Address - Country:US
Practice Address - Phone:240-397-6723
Practice Address - Fax:833-992-0865
Is Sole Proprietor?:No
Enumeration Date:2008-01-19
Last Update Date:2022-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA003605363AM0700X, 363AM0700X
PAMA057763363AM0700X
MDC03707363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical