Provider Demographics
NPI:1992792139
Name:BROWN, CARLTON Q (MD)
Entity type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:Q
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 SPRINGVALE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-3424
Mailing Address - Country:US
Mailing Address - Phone:703-759-3630
Mailing Address - Fax:
Practice Address - Street 1:507 SPRINGVALE RD
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:VA
Practice Address - Zip Code:22066-3424
Practice Address - Country:US
Practice Address - Phone:703-759-3630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039828207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01730M01OtherGROUP/INDIVIDUAL NUMBER
E77810Medicare UPIN