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General NPI Number Information
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NPI Number | 1629504212
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Entity Type | Organization
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Legal Business Name | BREWERMD PLLC
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 2435 KIMBERLY RD 96 SOUTH
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City | BETTENDORF
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State | IA
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Zip | 52722-3509
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Country | US
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Telephone | 563-259-7269
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Fax | 844-246-6378
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Provider Business Mailing Address
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Address Line | 5014 WYNDHAM CT
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City | BETTENDORF
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State | IA
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Zip | 52722-5390
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Country | US
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Telephone | 563-259-7269
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Fax | 844-246-6378
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHERRY RODDY BREWER
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Credential | MD
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Telephone | 563-259-7269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 41467
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License Number State | IA
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