Provider Demographics
NPI:1174917744
Name:BREWER, BRIAN N (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:N
Last Name:BREWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 48089
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30604-8089
Mailing Address - Country:US
Mailing Address - Phone:706-389-3727
Mailing Address - Fax:706-389-3951
Practice Address - Street 1:2470 DANIELLS BRIDGE RD STE 231
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6188
Practice Address - Country:US
Practice Address - Phone:706-769-3362
Practice Address - Fax:706-769-5675
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-22
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA84383207RS0010X, 207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Single Specialty