Individual
MARK S BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4600 LAKE BOONE TRAIL, SUITE 100, RALEIGH, NC 27607-7529
(919) 787-1374
(919) 571-8135
Mailing address
4600 LAKE BOONE TRAIL, SUITE 100, RALEIGH, NC 27607-7529
(919) 787-1374
(919) 571-8135
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35284
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040010824
RAILROAD MEDICARE
NC
01
—
1050085
UNITED HEALTHCARE
NC
01
—
19195
BLUE CROSS
NC
05
—
8919195
—
NC
Enumeration date
05/06/2006
Last updated
07/12/2021
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