MEDICARE: DR. CASSANDRA L BREWSTER MD

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	207Q00000X	Family Medicine Physician	2005036189	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	706E393	OTHER		MEDICARE INDIVIDUAL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	36302012	OTHER		BCBS GROUP NUMBER

General Provider Information

NPI Number	:	1801826193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CASSANDRA L BREWSTER MD

Provider Business Mailing Address
First Line	:	300 S MAIN ST
Second Line	:	P O BOX 788
City	:	PECULIAR
State	:	MO
Zip	:	64078-9603
Country	:	US
Telephone Number	:	816-779-1100
Fax Number	:	816-779-1119

Provider Business Practice Location Address
First Line	:	2820 E ROCK HAVEN RD STE 210
Second Line	:
City	:	HARRISONVILLE
State	:	MO
Zip	:	64701-4414
Country	:	US
Telephone Number	:	816-540-2111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	06/02/2025

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