Provider Demographics
NPI:1124074851
Name:BROWN, ROBERT OSBORNE III (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:OSBORNE
Last Name:BROWN
Suffix:III
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:PO BOX 604348
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-4348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 CONGAREE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3519
Practice Address - Country:US
Practice Address - Phone:864-248-4130
Practice Address - Fax:864-248-4131
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18591207YX0007X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC040015673OtherRAILROAD MEDICARE
SCP00801263OtherRR MEDICARE
SC185918Medicaid
SCP00801263OtherRR MEDICARE
SC040015673OtherRAILROAD MEDICARE
SC185918Medicaid
SC185918Medicaid