Provider Demographics
NPI:1366512154
Name:BROWN, KEVIN M (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:M
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1311 LONDONTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6454
Mailing Address - Country:US
Mailing Address - Phone:410-552-3822
Mailing Address - Fax:410-552-3823
Practice Address - Street 1:1311 LONDONTOWN BLVD
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6454
Practice Address - Country:US
Practice Address - Phone:410-552-3822
Practice Address - Fax:410-552-3823
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor