MEDICARE: JOHN BREWER MD

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	208000000X	Pediatrics Physician	19083	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00000003752	OTHER	KY	ANTHEM

General Provider Information

NPI Number	:	1548268584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN BREWER MD

Provider Business Mailing Address
First Line	:	708 OVERTON ST
Second Line	:
City	:	NEWPORT
State	:	KY
Zip	:	41071-2065
Country	:	US
Telephone Number	:	859-866-4749
Fax Number	:	513-631-7484

Provider Business Practice Location Address
First Line	:	708 OVERTON ST
Second Line	:
City	:	NEWPORT
State	:	KY
Zip	:	41071-2065
Country	:	US
Telephone Number	:	859-866-4749
Fax Number	:	513-631-7484

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	04/23/2015

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Directions to “ JOHN BREWER MD” Practice Location

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