MEDICARE: NOAH ROBERT BROWN

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1366283871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH ROBERT BROWN

Provider Business Mailing Address
First Line	:	1170 BAY LAUREL DR
Second Line	:
City	:	MARYSVILLE
State	:	OH
Zip	:	43040-8030
Country	:	US
Telephone Number	:	937-707-2070
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 BURR AVE STE 302A
Second Line	:
City	:	GRANDVIEW HEIGHTS
State	:	OH
Zip	:	43212-1189
Country	:	US
Telephone Number	:	937-707-2070
Fax Number	:

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

Provider Enumeration Date	:	06/06/2024
Last Update Date	:	08/15/2024

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Directions to “ NOAH ROBERT BROWN ” Practice Location

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