Provider Demographics
NPI:1306257415
Name:BROWNFIELD, AARON (MD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BROWNFIELD
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 1:202 8TH ST
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-2426
Mailing Address - Country:US
Mailing Address - Phone:540-639-5188
Mailing Address - Fax:540-639-9215
Practice Address - Street 1:202 8TH ST
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-2426
Practice Address - Country:US
Practice Address - Phone:540-639-5188
Practice Address - Fax:540-639-9215
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27644208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100474490Medicaid
WV1306257415Medicaid
WV7814OtherMEDICARE FFS