Provider Demographics
NPI:1326269374
Name:MARCUM, MIRIAM BROWN (MD)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:BROWN
Last Name:MARCUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST # C367
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-3215
Mailing Address - Country:US
Mailing Address - Phone:859-323-6051
Mailing Address - Fax:859-257-7899
Practice Address - Street 1:125 E MAXWELL ST STE 140
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2678
Practice Address - Country:US
Practice Address - Phone:859-323-0005
Practice Address - Fax:859-323-0790
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41183207VG0400X, 207VX0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics