Individual
MRS. TAIWANNA GRANAE BROWN-BOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
123 THREE RIVERS DR NE, ROME, GA 30161-2300
(706) 295-3961
Mailing address
420 E 2ND AVE STE 103, ROME, GA 30161-3210
(706) 509-3000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
046047
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00838142A
—
GA
Enumeration date
10/04/2006
Last updated
03/07/2023
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