Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | H0085213 | MD |
NPI | 1003203126 |
---|---|
Provider Name | Bethany Brown |
First Address | Owings Mills, MD 21117-5623 |
Second Address | Owings Mills, MD 21117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2015 |
Last Update Date | 22/05/2018 |