Provider Demographics
NPI:1518046127
Name:BROWN, MATTHEW WILSON I
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:WILSON
Last Name:BROWN
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 BRIGHTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7987
Mailing Address - Country:US
Mailing Address - Phone:803-741-1271
Mailing Address - Fax:803-741-7429
Practice Address - Street 1:90 BRIGHTON HILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7987
Practice Address - Country:US
Practice Address - Phone:803-741-1271
Practice Address - Fax:803-741-7429
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health