MEDICARE: DR. MADELINE NICOLE BOTA BROWN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MT234482	PA

General Provider Information

NPI Number	:	1184416513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADELINE NICOLE BOTA BROWN MD

Provider Business Mailing Address
First Line	:	9109 GARDEN KNOLL LN
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-2519
Country	:	US
Telephone Number	:	484-350-8082
Fax Number	:

Provider Business Practice Location Address
First Line	:	9109 GARDEN KNOLL LN
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-2519
Country	:	US
Telephone Number	:	484-350-8082
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2025
Last Update Date	:	05/21/2025

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