Healthcare Provider Details

I. General information

NPI: 1962659011
Provider Name (Legal Business Name): BEVERLY A BROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5324 PENN AVE
PITTSBURGH PA
15224-1733
US

IV. Provider business mailing address

825 WHITE OAK CIR
PITTSBURGH PA
15228-1711
US

V. Phone/Fax

Practice location:
  • Phone: 412-441-4884
  • Fax: 412-441-0167
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD463263
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: