Provider Demographics
NPI:1265611487
Name:DAVID BROWN DBA CUMBERLAND MEDICAL
Entity type:Organization
Organization Name:DAVID BROWN DBA CUMBERLAND MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-492-9086
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23040-0026
Mailing Address - Country:US
Mailing Address - Phone:804-492-9086
Mailing Address - Fax:
Practice Address - Street 1:1758 ANDERSON HWY
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:VA
Practice Address - Zip Code:23040-2524
Practice Address - Country:US
Practice Address - Phone:804-492-9086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1619072626OtherINDIVIDUAL NPI
DD5674OtherMEDICARE RAIL ROAD
C09586Medicare PIN
1619072626OtherINDIVIDUAL NPI