Basic Information
Provider Information
NPI: 1821072893
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWNE
FirstName: JAMES
MiddleName: DALE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 344
Address2:  
City: WINSTON SALEM
State: NC
PostalCode: 271020344
CountryCode: US
TelephoneNumber: 3367162255
FaxNumber: 3367169440
Practice Location
Address1: MEDICAL CENTER BLVD
Address2:  
City: WINSTON SALEM
State: NC
PostalCode: 271570001
CountryCode: US
TelephoneNumber: 3367162255
FaxNumber: 3367169440
Other Information
ProviderEnumerationDate: 12/02/2005
LastUpdateDate: 08/19/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207YX0007X27432NCY Allopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
207YX0901X27432NCN Allopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology

ID Information
IDTypeStateIssuerDescription
370301 PARTNERSOTHER
1920901 BCBSOTHER
4001696501 RR MEDICAREOTHER
22037400005WV MEDICAID
652028605VA MEDICAID
891920905NC MEDICAID
Q2743205SC MEDICAID
566103001 AETNAOTHER
4244501 MEDCOSTOTHER


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