Provider Demographics
NPI:1962525204
Name:BREWER, PAUL ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANDREW
Last Name:BREWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 WELCH ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381
Mailing Address - Country:US
Mailing Address - Phone:503-874-2454
Mailing Address - Fax:503-779-2229
Practice Address - Street 1:452 WELCH ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381
Practice Address - Country:US
Practice Address - Phone:503-874-2454
Practice Address - Fax:503-874-2454
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD169084207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAVAD 000Medicare UPIN