MEDICARE: JUSTIN THOMAS BROWN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0070977	MD

General Provider Information

NPI Number	:	1518286970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN THOMAS BROWN MD

Provider Business Mailing Address
First Line	:	12210 PLUM ORCHARD DR
Second Line	:	SUITE 212
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7800
Country	:	US
Telephone Number	:	301-622-6020
Fax Number	:	301-680-9335

Provider Business Practice Location Address
First Line	:	12210 PLUM ORCHARD DR
Second Line	:	SUITE 212
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7800
Country	:	US
Telephone Number	:	301-622-6020
Fax Number	:	301-680-9335

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2010
Last Update Date	:	06/16/2016

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