Provider Demographics
NPI:1801960273
Name:BROWN, DOUGLAS M (R PH)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:M
Last Name:BROWN
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6112 ONSLOW CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7046
Mailing Address - Country:US
Mailing Address - Phone:804-364-8686
Mailing Address - Fax:
Practice Address - Street 1:4300 COX RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3358
Practice Address - Country:US
Practice Address - Phone:804-965-7695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202009370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist