NPI Code Details Logo

NPI 1356299093

NPI 1356299093 : CARL BREWER : MARIETTA, GA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1356299093
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CARL BREWER
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/18/2026
-----------------------------------------------------
    Last Update Date     |    03/18/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    531 ROSELANE ST NW STE 400 
-----------------------------------------------------
    City                 |    MARIETTA
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30060-6971
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    678-369-1950
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    531 ROSELANE ST NW STE 400 
-----------------------------------------------------
    City                 |    MARIETTA
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30060-6971
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    678-369-1950
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    374U00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Aide
-----------------------------------------------------
    License Number       |    PHCP044079
-----------------------------------------------------
    License Number State |    GA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.