MEDICARE: MS. MIRIAM WEISS BROWN M.D.

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	2084P0804X	Child & Adolescent Psychiatry Physician	4301511484	MI

General Provider Information

NPI Number	:	1689230476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MIRIAM WEISS BROWN M.D.

Provider Business Mailing Address
First Line	:	3600 FORBES AVENUE
Second Line	:	FORBES TOWER - PLAZA LEVEL SUITE 140
City	:	PITTSBURGH
State	:	PA
Zip	:	15213
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4230 COPPER RIDGE DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7256
Country	:	US
Telephone Number	:	231-935-6380
Fax Number	:

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

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	12/19/2025

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