Individual
MICHAEL L. BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 WABASH AVE, SPRINGFIELD, IL 62704-5352
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-057017
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057017
—
IL
Enumeration date
08/30/2006
Last updated
12/05/2008
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