MEDICARE: MARIA BROWN DO

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	207Q00000X	Family Medicine Physician	036-069059	IL
2	207Q00000X	Family Medicine Physician	02005545A	IN

General Provider Information

NPI Number	:	1932290343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA BROWN DO

Provider Business Mailing Address
First Line	:	5920 WARNKE RD
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-9642
Country	:	US
Telephone Number	:	773-551-5008
Fax Number	:

Provider Business Practice Location Address
First Line	:	5920 WARNKE RD
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-9642
Country	:	US
Telephone Number	:	773-551-5008
Fax Number	:

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	06/21/2026

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