Provider Demographics
NPI:1366406621
Name:DREW, BRIAN RAY (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:RAY
Last Name:DREW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6525 FRANCE AVE S
Mailing Address - Street 2:SUITE 325
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2148
Mailing Address - Country:US
Mailing Address - Phone:952-920-4595
Mailing Address - Fax:952-920-7958
Practice Address - Street 1:6525 FRANCE AVE S
Practice Address - Street 2:SUITE 325
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2148
Practice Address - Country:US
Practice Address - Phone:952-920-4595
Practice Address - Fax:952-920-7958
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNPENDING207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology