Provider Demographics
NPI:1356335954
Name:BROWN, ADAM CRAIG (DPM)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CRAIG
Last Name:BROWN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1483 TOBIAS GADSON BLVD STE 107B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4795
Mailing Address - Country:US
Mailing Address - Phone:843-225-5575
Mailing Address - Fax:843-326-4943
Practice Address - Street 1:1483 TOBIAS GADSON BLVD STE 107B
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4795
Practice Address - Country:US
Practice Address - Phone:843-225-5575
Practice Address - Fax:843-326-4943
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC545213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPD5453Medicaid
SCPD5453Medicaid