Provider Demographics
NPI:1679801500
Name:BROWN, ALEKSANDRA G (DO)
Entity Type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:G
Last Name:BROWN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 S MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7006
Mailing Address - Country:US
Mailing Address - Phone:540-951-3376
Mailing Address - Fax:
Practice Address - Street 1:3706 S MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-7006
Practice Address - Country:US
Practice Address - Phone:540-951-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.003160390200000X
MI5101018951207N00000X
VA0102203481207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program