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General NPI Number Information
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NPI Number | 1689230476
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Entity Type | Individual
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Provider Name | MIRIAM WEISS BROWN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 4230 COPPER RIDGE DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-7256
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Country | US
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Telephone | 231-935-6380
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 FORBES AVENUE FORBES TOWER - PLAZA LEVEL SUITE 140
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City | PITTSBURGH
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State | PA
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Zip | 15213
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 4301511484
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License Number State | MI
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