Individual
HEIDI A BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
205 FRENCH ST, BANGOR, ME 04401-5064
(207) 945-5554
(207) 945-5196
Mailing address
205 FRENCH ST, BANGOR, ME 04401-5064
(207) 945-5554
(207) 945-5196
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
POD1032
ME
213ES0131X
Foot Surgery Podiatrist
POD1032
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010362456
FED TAX I D NUMBER
ME
05
—
222840000
—
ME
Enumeration date
01/19/2007
Last updated
08/10/2015
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