Healthcare Provider Details

I. General information

NPI: 1750551016
Provider Name (Legal Business Name): THOMAS.E. BREWINGTON, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 SUMMIT AVE
GREENSBORO NC
27405-7833
US

IV. Provider business mailing address

807 SUMMIT AVE
GREENSBORO NC
27405-7833
US

V. Phone/Fax

Practice location:
  • Phone: 336-272-5628
  • Fax: 336-273-1671
Mailing address:
  • Phone: 336-272-5628
  • Fax: 336-273-1671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS E. BREWINGTON JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 336-272-5628