Healthcare Provider Details

I. General information

NPI: 1568374957
Provider Name (Legal Business Name): MAYA BREWER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 WALDEMERE AVE
INDIANAPOLIS IN
46241-7234
US

IV. Provider business mailing address

3737 WALDEMERE AVE
INDIANAPOLIS IN
46241-7234
US

V. Phone/Fax

Practice location:
  • Phone: 463-374-3842
  • Fax:
Mailing address:
  • Phone: 463-374-3842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number50047
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26032177A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: