Individual
JOHN C BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
19 S GORHAM XING, GORHAM, ME 04038-2690
(207) 839-9101
(207) 839-9201
Mailing address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1161
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117980000
—
ME
05
—
117980099
—
ME
Enumeration date
10/11/2006
Last updated
01/16/2012
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