Organization
JUDSON L BREWER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDSON BREWER (PRESIDENT)
(812) 323-0406
Entity
Organization
Contact information
Practice address
717 W 1ST ST, BLOOMINGTON, IN 47403-2319
(812) 323-0406
Mailing address
717 W 1ST ST, BLOOMINGTON, IN 47403-2319
(812) 323-0406
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000176207
ANTHEM BS
IN
01
—
P00016717
TRAVELERS MEDICARE
IN
Enumeration date
03/22/2007
Last updated
10/18/2007
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