Healthcare Provider Details

I. General information

NPI: 1063454403
Provider Name (Legal Business Name): DIANE BROWNE YOUNG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANE MARIE BROWN PA-C

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3407 WILKENS AVE STE 210
BALTIMORE MD
21229-5221
US

IV. Provider business mailing address

10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US

V. Phone/Fax

Practice location:
  • Phone: 410-644-0929
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA031318
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9817
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-10978
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0003237
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: