MEDICARE: MS. PAMELA MARIE 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	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker	6801120172	MI
3	3747A0650X	Attendant Care Provider
4	104100000X	Social Worker	6803088663	MI

General Provider Information

NPI Number	:	1518128099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA MARIE BROWN

Provider Business Mailing Address
First Line	:	922 BUCKINGHAM AVE
Second Line	:
City	:	LINCOLN PARK
State	:	MI
Zip	:	48146-3639
Country	:	US
Telephone Number	:	313-207-9651
Fax Number	:	313-905-4835

Provider Business Practice Location Address
First Line	:	922 BUCKINGHAM AVE
Second Line	:
City	:	LINCOLN PARK
State	:	MI
Zip	:	48146-3639
Country	:	US
Telephone Number	:	313-207-9651
Fax Number	:	313-905-4835

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

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	03/11/2026

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