Provider Demographics
NPI:1871136713
Name:BROWN, ERIC STUART SR
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:STUART
Last Name:BROWN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6915 WINDY CREEK TER
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-9294
Mailing Address - Country:US
Mailing Address - Phone:804-366-9199
Mailing Address - Fax:
Practice Address - Street 1:6915 WINDY CREEK TER
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-9294
Practice Address - Country:US
Practice Address - Phone:804-366-9199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty