Provider Demographics
NPI:1891908661
Name:BROWN, RONALD STEPHEN
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:STEPHEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 N NELSON ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3841
Mailing Address - Country:US
Mailing Address - Phone:703-528-2816
Mailing Address - Fax:
Practice Address - Street 1:4400 JENIFER ST NW STE 270
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2113
Practice Address - Country:US
Practice Address - Phone:202-964-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC29231223P0106X
VA41701223P0106X
MD56211223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC11689844OtherCAQH PROVIDER NUMBER
DC668010Medicare ID - Type UnspecifiedPROVIDER NUMBER
DC11689844OtherCAQH PROVIDER NUMBER