Provider Demographics
NPI:1629080650
Name:WILLIAM G BROWN MD DERMATOLOGY & ASSOC,LLC
Entity Type:Organization
Organization Name:WILLIAM G BROWN MD DERMATOLOGY & ASSOC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:FERBER
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-768-7979
Mailing Address - Street 1:1591 MARCO DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-4836
Mailing Address - Country:US
Mailing Address - Phone:410-255-4616
Mailing Address - Fax:410-437-4379
Practice Address - Street 1:808 LANDMARK DR
Practice Address - Street 2:SUITE 120
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122
Practice Address - Country:US
Practice Address - Phone:410-768-7979
Practice Address - Fax:410-768-7983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD014MMedicare ID - Type Unspecified