Basic Information
| Provider Information | |||||||||
| NPI: | 1326269374 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARCUM | ||||||||
| FirstName: | MIRIAM | ||||||||
| MiddleName: | BROWN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 ROSE ST # C367 | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405363215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593236051 | ||||||||
| FaxNumber: | 8592577899 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 E MAXWELL ST STE 140 | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405082678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593230005 | ||||||||
| FaxNumber: | 8593230790 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 08/07/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 41183 | KY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 207VX0000X | 41183 | KY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | 207V00000X | 41183 | KY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.