Individual
GARY BREWER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
216 ANAMARIA DR, RAPID CITY, SD 57701-7366
(605) 721-0337
(605) 721-0043
Mailing address
623 WESTWIND DR, RAPID CITY, SD 57702-2067
(605) 343-5279
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R021761
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5750045
—
SD
Enumeration date
09/12/2005
Last updated
07/08/2007
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