MEDICARE: MS. PAMELA D. BROWN-WHITE PT, MBA

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	2251P0200X	Pediatric Physical Therapist	PT2248	DC
2	2251P0200X	Pediatric Physical Therapist	18827	MD

General Provider Information

NPI Number	:	1578896726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA D. BROWN-WHITE PT, MBA

Provider Business Mailing Address
First Line	:	PO BOX 29680
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-0880
Country	:	US
Telephone Number	:	202-832-3590
Fax Number	:	202-832-8494

Provider Business Practice Location Address
First Line	:	3321 12TH ST NE
Second Line	:	SUITE 2
City	:	WASHINGTON
State	:	DC
Zip	:	20017-4008
Country	:	US
Telephone Number	:	202-832-3590
Fax Number	:	202-832-8494

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

Provider Enumeration Date	:	09/04/2009
Last Update Date	:	09/04/2009

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Directions to “ MS. PAMELA D. BROWN-WHITE PT, MBA” Practice Location

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