Provider Demographics
NPI:1851307755
Name:BROWN, CHARLES L III (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:L
Last Name:BROWN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:95 COLLIER RD NW
Mailing Address - Street 2:SUITE 2065
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1796
Mailing Address - Country:US
Mailing Address - Phone:404-605-2800
Mailing Address - Fax:404-720-0911
Practice Address - Street 1:95 COLLIER RD NW
Practice Address - Street 2:SUITE 2065
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1796
Practice Address - Country:US
Practice Address - Phone:404-605-2800
Practice Address - Fax:404-720-0911
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2023-05-03
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Provider Licenses
StateLicense IDTaxonomies
GA028383207RI0011X
GA28383207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000611476EFGHJKLMedicaid
GAD44931Medicare UPIN
GA202I061103Medicare PIN