Provider Demographics
NPI:1932793593
Name:BROWN, WILLIAM DAVID (REHS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:BROWN
Suffix:
Gender:M
Credentials:REHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 MAIL SERVICE CTR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27699-1632
Mailing Address - Country:US
Mailing Address - Phone:919-707-5950
Mailing Address - Fax:919-870-4808
Practice Address - Street 1:5605 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3811
Practice Address - Country:US
Practice Address - Phone:919-707-5950
Practice Address - Fax:919-870-4808
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local