Provider Demographics
NPI:1023887387
Name:BROWN, JAMES (MAIE INC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:MAIE INC
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6131
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-0131
Mailing Address - Country:US
Mailing Address - Phone:757-675-3395
Mailing Address - Fax:
Practice Address - Street 1:5323 BAYSIDE RD UNIT A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-3705
Practice Address - Country:US
Practice Address - Phone:757-675-3395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA07709819171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor