Provider Demographics
NPI:1609958529
Name:WILLIAM J BROWNLEE M D LLC
Entity Type:Organization
Organization Name:WILLIAM J BROWNLEE M D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BROWNLEE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:202-526-0200
Mailing Address - Street 1:1809 REDWOOD TER NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1022
Mailing Address - Country:US
Mailing Address - Phone:202-526-0200
Mailing Address - Fax:202-832-3476
Practice Address - Street 1:1160 VARNUM ST NE STE 213
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2106
Practice Address - Country:US
Practice Address - Phone:202-526-0200
Practice Address - Fax:202-832-3476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD21292208600000X, 2086S0102X, 2086S0127X, 2086S0129X, 2086X0206X, 208C00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00731Medicare ID - Type UnspecifiedMC GROUP NUMBER
DC00A912W31Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL
H24223Medicare UPIN