Provider Demographics
NPI:1811567522
Name:BROWN, CHARLES DANIEL (NEMT)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:DANIEL
Last Name:BROWN
Suffix:
Gender:M
Credentials:NEMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 SAVANNAH AVE
Mailing Address - Street 2:
Mailing Address - City:EAST DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31027-3339
Mailing Address - Country:US
Mailing Address - Phone:478-772-1521
Mailing Address - Fax:478-772-1521
Practice Address - Street 1:221 SAVANNAH AVE
Practice Address - Street 2:
Practice Address - City:EAST DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31027-3339
Practice Address - Country:US
Practice Address - Phone:478-772-1521
Practice Address - Fax:478-304-0508
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-26
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty