Provider Demographics
NPI:1487603809
Name:BROWNLEE, NOEL ANDERSON (MD, PHD)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:ANDERSON
Last Name:BROWNLEE
Suffix:
Gender:M
Credentials:MD, PHD
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 9280
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29604-9280
Mailing Address - Country:US
Mailing Address - Phone:864-255-1048
Mailing Address - Fax:
Practice Address - Street 1:8 MEMORIAL MEDICAL CT
Practice Address - Street 2:SUITE 1
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4449
Practice Address - Country:US
Practice Address - Phone:864-295-3492
Practice Address - Fax:864-295-4817
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30325207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC303255Medicaid
SCAA22577135OtherMEDICARE PTAN
SCAA22577135OtherMEDICARE PTAN
SCI541077135Medicare PIN