MEDICARE: FORD BREWER, MD, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1356628390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORD BREWER, MD, INC

Provider Business Mailing Address
First Line	:	5500 MARYLAND WAY
Second Line	:	SUITE 400
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4948
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 JOAQUIN RD
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94043-1242
Country	:	US
Telephone Number	:	650-253-8476
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VP
Name	:	STUART CLARK
Credential	:
Telephone Number	:	703-760-0700

Provider Enumeration Date	:	11/04/2011
Last Update Date	:	07/07/2016

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Directions to “FORD BREWER, MD, INC ” Practice Location

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