Provider Demographics
NPI:1215209275
Name:BREWER, DEBBIE RENEE (MD)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:RENEE
Last Name:BREWER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4529 CABINWOOD TURN
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1959
Mailing Address - Country:US
Mailing Address - Phone:404-587-6038
Mailing Address - Fax:679-336-1694
Practice Address - Street 1:6853 DOUGLAS BLVD STE C
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-7179
Practice Address - Country:US
Practice Address - Phone:678-266-7150
Practice Address - Fax:678-336-1694
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050943207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00961639AMedicaid
GA00961639AMedicaid