Provider Demographics
NPI:1427120922
Name:WHITEHURST BROWN, DEBRA V (MD)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:V
Last Name:WHITEHURST BROWN
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:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:443-481-6467
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:4175 N HANSON CT
Practice Address - Street 2:#209
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3179
Practice Address - Country:US
Practice Address - Phone:301-352-4007
Practice Address - Fax:301-352-3316
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0039708207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y8880002OtherBCBS
4228811OtherAETNA
52061204OtherBCBS MD RENDERING
MD556331300Medicaid
X99764OtherMD UPIN
X99764OtherMD UPIN
MD556331300Medicaid
MD231644YBL9Medicare PIN
Y8880002OtherBCBS