Provider Demographics
NPI:1487603700
Name:BROWN, MARK S (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:S
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4600 LAKE BOONE TRAIL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7529
Mailing Address - Country:US
Mailing Address - Phone:919-787-1374
Mailing Address - Fax:919-571-8135
Practice Address - Street 1:4600 LAKE BOONE TRAIL
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7529
Practice Address - Country:US
Practice Address - Phone:919-787-1374
Practice Address - Fax:919-571-8135
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2021-07-12
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Provider Licenses
StateLicense IDTaxonomies
MD35284207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC19195OtherBLUE CROSS
NC040010824OtherRAILROAD MEDICARE
NC1050085OtherUNITED HEALTHCARE
NC8919195Medicaid
NC19195OtherBLUE CROSS
NCE94075Medicare UPIN