Healthcare Provider Details

I. General information

NPI: 1184911703
Provider Name (Legal Business Name): SHAWN ELIZABETH-BOTT BROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2011
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 W WASHINGTON ST STE A
MARQUETTE MI
49855-4031
US

IV. Provider business mailing address

1025 W WASHINGTON ST STE A
MARQUETTE MI
49855-4031
US

V. Phone/Fax

Practice location:
  • Phone: 906-239-5050
  • Fax: 906-239-5055
Mailing address:
  • Phone: 906-239-5050
  • Fax: 906-239-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number57700
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301098626
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number57700
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: