Provider Demographics
NPI:1710326780
Name:BROWN, SAMUEL EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:EDWARD
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:540 OWENS FARM RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-3797
Mailing Address - Country:US
Mailing Address - Phone:404-966-6464
Mailing Address - Fax:678-624-9976
Practice Address - Street 1:540 OWENS FARM RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-3797
Practice Address - Country:US
Practice Address - Phone:404-966-6464
Practice Address - Fax:678-624-9976
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-22
Last Update Date:2013-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA171402085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology