Healthcare Provider Details

I. General information

NPI: 1932913274
Provider Name (Legal Business Name): MICHAEL BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 ANNAPOLIS RD
LANHAM MD
20706-3115
US

IV. Provider business mailing address

6416 NW 5TH WAY
FORT LAUDERDALE FL
33309-6112
US

V. Phone/Fax

Practice location:
  • Phone: 240-296-6076
  • Fax: 301-263-7942
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: