MEDICARE: MR. MARC CHRISTOPHER BREWER PT

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	225100000X	Physical Therapist	PT-09206	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00288201	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9342317	OTHER	OH	PHCS
2	000000328337	OTHER	OH	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396743134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARC CHRISTOPHER BREWER PT

Provider Business Mailing Address
First Line	:	4440 GLEN ESTE WITHAMSVILLE RD
Second Line	:	SUITE 500
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1318
Country	:	US
Telephone Number	:	513-794-3363
Fax Number	:	513-753-4308

Provider Business Practice Location Address
First Line	:	4440 GLEN ESTE WITHAMSVILLE RD
Second Line	:	SUITE 500
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1318
Country	:	US
Telephone Number	:	513-794-3363
Fax Number	:	513-753-4308

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	02/03/2014

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