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Individual

MS. SUZANNE LEE BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
501 RAILROAD AVE, ELKINS, WV 26241
(304) 636-5006
(304) 636-4898
Mailing address
501 RAILROAD AVE, ELKINS, WV 26241
(304) 636-5006
(304) 636-4898

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00765
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001719255
MOUNTAIN STATE BCBS
WV
01
P00328097
RAILROAD MEDICARE
WV
01
WV765
HEALTH PLAN
WV
Enumeration date
07/19/2006
Last updated
06/17/2021
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