Provider Demographics
NPI:1194706598
Name:BROWN, DAVID HAMILTON (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:HAMILTON
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90
Mailing Address - Street 2:125 BUENA VISTA CIRCLE
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-0090
Mailing Address - Country:US
Mailing Address - Phone:434-447-3151
Mailing Address - Fax:434-774-2452
Practice Address - Street 1:125 BUENA VISTA CIR
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1431
Practice Address - Country:US
Practice Address - Phone:434-447-3151
Practice Address - Fax:434-774-2452
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047809207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7906008Medicaid
VA33250Medicaid
454170OtherANTHEM BLUE CROSS
VA5869927Medicaid
VA33250Medicaid