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General NPI Number Information
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NPI Number | 1477261931
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Entity Type | Individual
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Provider Name | MARYLEE R BREHMER PC-C
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Gender | Female
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 1120 15TH ST
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-5561
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Fax |
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Provider Business Mailing Address
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Address Line | 1612 BREHMER RD
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City | KINARDS
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State | SC
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Zip | 29355-9340
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Country | US
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Telephone | 803-924-8320
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 11349
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License Number State | GA
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