Provider Demographics
NPI:1285796367
Name:BRABHAM, FELICIA BROWNE (MD)
Entity type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:BROWNE
Last Name:BRABHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 FLEMING ST STE C
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4250
Mailing Address - Country:US
Mailing Address - Phone:828-693-9669
Mailing Address - Fax:828-693-3800
Practice Address - Street 1:510 FLEMING ST STE C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4250
Practice Address - Country:US
Practice Address - Phone:828-693-9669
Practice Address - Fax:828-693-3800
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31248207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8917346Medicaid
562036779OtherTIN
204953AMedicare ID - Type Unspecified
NC8917346Medicaid