Provider Demographics
NPI:1275858128
Name:BREWER, DAVID MATTHEW (DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MATTHEW
Last Name:BREWER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 COLLEGE HEIGHTS BLVD
Mailing Address - Street 2:STE 2400
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4817
Mailing Address - Country:US
Mailing Address - Phone:610-432-7733
Mailing Address - Fax:610-432-7733
Practice Address - Street 1:7618 OGONTZ AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-1817
Practice Address - Country:US
Practice Address - Phone:267-323-2778
Practice Address - Fax:267-323-2774
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPTO-20454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2156631OtherHIGHMARK PA BLUE SHIELD
PA30078791OtherKEYSTONE MERCY
306073OtherUNISON
PA102448115-001Medicaid
PA3777092000OtherINDEPENDENCE BLUE CROSS
PA2156631OtherHIGHMARK PA BLUE SHIELD