Provider Demographics
NPI:1790965986
Name:BROWN, CAROLINE THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:THOMAS
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 KNOLLWOOD ST STE H298
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1884
Mailing Address - Country:US
Mailing Address - Phone:336-815-4890
Mailing Address - Fax:
Practice Address - Street 1:1400 WESTGATE CENTER DR STE 206
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3104
Practice Address - Country:US
Practice Address - Phone:336-815-4890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-01034208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5915580Medicaid