MEDICARE: DR. MARISA ANN BRAWERMAN PT , DPT

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	225100000X	Physical Therapist	25938	MD

General Provider Information

NPI Number	:	1609229483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARISA ANN BRAWERMAN PT , DPT

Provider Business Mailing Address
First Line	:	966 COACHWAY
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-6411
Country	:	US
Telephone Number	:	443-271-2530
Fax Number	:

Provider Business Practice Location Address
First Line	:	11333 WOODGLEN DR STE 204
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-3081
Country	:	US
Telephone Number	:	443-271-2530
Fax Number	:

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

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	09/17/2019

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