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Individual
DWIGHT K BROWN
Active
Individual
DWIGHT K BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003871
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002284A
—
GA
05
—
100002284B
—
GA
05
—
100002835A
—
GA
05
—
100002835C
—
GA
01
—
10059040
AMERIGROUP
GA
Enumeration date
06/26/2006
Last updated
10/19/2010
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