Healthcare Provider Details

I. General information

NPI: 1568601573
Provider Name (Legal Business Name): SHERAHE BROWN FITZPATRICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8702 MILFORD AVE
SILVER SPRING MD
20910-5031
US

IV. Provider business mailing address

8702 MILFORD AVE
SILVER SPRING MD
20910-5031
US

V. Phone/Fax

Practice location:
  • Phone: 301-495-9699
  • Fax:
Mailing address:
  • Phone: 301-495-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0042348
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD12526
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: