Provider Demographics
NPI:1700386604
Name:BREWER, CHARLES RICHARD (PA-C)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:RICHARD
Last Name:BREWER
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:PO BOX 555
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37077-0555
Mailing Address - Country:US
Mailing Address - Phone:615-864-2002
Mailing Address - Fax:
Practice Address - Street 1:125 MAPLE ROW BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3909
Practice Address - Country:US
Practice Address - Phone:615-991-3158
Practice Address - Fax:615-667-6568
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2025-02-26
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical