Individual
LEE J BREWERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
105572
MN
2085R0202X
Diagnostic Radiology Physician
Primary
54363
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00992441
RAILROAD MEDICARE
MN
Enumeration date
07/29/2011
Last updated
02/03/2012
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