Provider Demographics
NPI:1235573114
Name:BREWER, ANN CHANG (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:CHANG
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 1:1300 N HOLOPONO ST
Mailing Address - Street 2:STE 215
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-6945
Mailing Address - Country:US
Mailing Address - Phone:808-874-3444
Mailing Address - Fax:
Practice Address - Street 1:175 COMMONS LOOP STE 300
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1904
Practice Address - Country:US
Practice Address - Phone:406-756-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49545207N00000X
AZR73761207N00000X
MT56288207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology