Provider Demographics
NPI:1467788596
Name:BROWN, DAVID PAUL (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:BROWN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:N BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01862-2603
Mailing Address - Country:US
Mailing Address - Phone:978-663-8747
Mailing Address - Fax:978-667-3827
Practice Address - Street 1:205 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1434
Practice Address - Country:US
Practice Address - Phone:978-681-9943
Practice Address - Fax:978-681-5048
Is Sole Proprietor?:No
Enumeration Date:2009-10-24
Last Update Date:2009-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16512183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist