MEDICARE: BRIANNA MEW D.O.

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	MED-PHYS-LIC-66806	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972982288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA MEW D.O.

Provider Business Mailing Address
First Line	:	PO BOX 808
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99210-0808
Country	:	US
Telephone Number	:	509-935-6001
Fax Number	:	509-935-4196

Provider Business Practice Location Address
First Line	:	2230 N RESERVE ST STE 402
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-1364
Country	:	US
Telephone Number	:	406-493-3120
Fax Number	:

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

Provider Enumeration Date	:	05/20/2015
Last Update Date	:	03/29/2024

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