MEDICARE: MONTIKA MICKIERA CARTER-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	342000000X	Transportation Network Company

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C-636-609-603-500	OTHER	MD	MVA

General Provider Information

NPI Number	:	1841863198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONTIKA MICKIERA CARTER-BROWN

Provider Business Mailing Address
First Line	:	8401 FORESIGHT LN
Second Line	:
City	:	WALKERSVILLE
State	:	MD
Zip	:	21793-7855
Country	:	US
Telephone Number	:	717-820-6379
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 FORESIGHT LN
Second Line	:
City	:	WALKERSVILLE
State	:	MD
Zip	:	21793-7855
Country	:	US
Telephone Number	:	717-820-6379
Fax Number	:

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

Provider Enumeration Date	:	07/22/2021
Last Update Date	:	07/22/2021

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Directions to “ MONTIKA MICKIERA CARTER-BROWN ” Practice Location

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