Individual
ELLEN RENEE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
184 HOLIDAY HILLS DR, PARKERSBURG, WV 26104-8006
(304) 420-2400
(304) 420-9014
Mailing address
602 17TH ST, VIENNA, WV 26105-1104
(304) 482-5449
(304) 461-7082
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
042-0011212
VT
207Q00000X
Family Medicine Physician
21389
WV
207Q00000X
Family Medicine Physician
35.099978
OH
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
21389
WV
207QA0401X
Addiction Medicine (Family Medicine) Physician
35.099978
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075906
—
OH
05
—
1012998
—
VT
05
—
3810023925
—
WV
01
—
P01138126
RAILROAD MEDICARE
OH
Enumeration date
06/02/2006
Last updated
09/30/2024
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