Individual
JOHN BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
708 OVERTON ST, NEWPORT, KY 41071-2065
(859) 866-4749
(513) 631-7484
Mailing address
708 OVERTON ST, NEWPORT, KY 41071-2065
(859) 866-4749
(513) 631-7484
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19083
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000003752
ANTHEM
KY
05
—
64190838
—
KY
Enumeration date
07/13/2005
Last updated
04/23/2015
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