Provider Demographics
NPI:1841294824
Name:BROWN, PAUL SHERMAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SHERMAN
Last Name:BROWN
Suffix:JR
Gender:
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 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2205 MCCABES GRANT CT
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-8713
Practice Address - Country:US
Practice Address - Phone:804-709-6808
Practice Address - Fax:804-681-0445
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101265546208600000X, 2086S0129X, 208G00000X
ND21945208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1841294824Medicaid
630081Medicare UPIN
PA050155Medicare ID - Type Unspecified