Individual
CAROLINE PRUITT BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1501 N MAIN ST, ANDERSON, SC 29621
(864) 716-0063
(864) 716-0073
Mailing address
1501 N MAIN ST, ANDERSON, SC 29621-4734
(864) 716-0063
(864) 716-0073
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
A673
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02419A
—
SC
01
—
196109
MEDCOST
SC
01
—
P00140954
RAILROAD MEDICARE
SC
Enumeration date
03/21/2006
Last updated
02/28/2019
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