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General NPI Number Information
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NPI Number | 1619150539
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Entity Type | Organization
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Legal Business Name | GREGORY BREWER, M.D.,PLLC
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 314 PROSPERITY DRIVE
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City | KNOXVILLE
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State | TN
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Zip | 37923
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Country | US
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Telephone | 865-691-8011
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31993
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City | KNOXVILLE
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State | TN
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Zip | 37930-1993
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Country | US
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Telephone | 865-691-8011
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY BREWER
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Credential | M.D.
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Telephone | 865-691-8011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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