Provider Demographics
NPI:1013970847
Name:DAVIS BROWN, ANGELA D (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:DAVIS BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:405 SILVERSIDE RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-1774
Mailing Address - Country:US
Mailing Address - Phone:302-798-0666
Mailing Address - Fax:302-798-4905
Practice Address - Street 1:2600 GLASGOW AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4773
Practice Address - Country:US
Practice Address - Phone:302-836-4200
Practice Address - Fax:302-836-8431
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD070690L207Q00000X
DEC1-0010236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1013970847Medicaid
DE1013970847Medicaid
H24668Medicare UPIN
H24668Medicare UPIN