Provider Demographics
NPI:1972681096
Name:BROWN, WHITNEY WINN (MD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:WINN
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:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:9 RICHLAND MEDICAL PARK DR STE 230
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-7990
Practice Address - Fax:803-434-8606
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN436882080P0205X
SC23876208000000X, 2080P0205X
AL266812080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC238763Medicaid
AL009997545Medicaid
TN1506039Medicaid
AL009997535Medicaid
SCAA66032389OtherMEDICARE PTAN
I31189Medicare UPIN
SCI31189Medicare UPIN
TN3001805Medicare PIN