Provider Demographics
NPI:1669241394
Name:BROWN, ANTHONY
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 W WENDOVER AVE # 1145
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1909
Mailing Address - Country:US
Mailing Address - Phone:336-316-8198
Mailing Address - Fax:
Practice Address - Street 1:7122 WHITETAIL DR
Practice Address - Street 2:
Practice Address - City:JULIAN
Practice Address - State:NC
Practice Address - Zip Code:27283-8307
Practice Address - Country:US
Practice Address - Phone:815-200-9124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company