Provider Demographics
NPI:1417981846
Name:BREWER, JOSEPH H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:H
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 1:4320 WORNALL ROAD
Mailing Address - Street 2:SUITE 440
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:66211-1335
Mailing Address - Country:US
Mailing Address - Phone:816-531-1550
Mailing Address - Fax:
Practice Address - Street 1:4320 WORNALL RD
Practice Address - Street 2:SUITE 440
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5941
Practice Address - Country:US
Practice Address - Phone:816-531-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7911207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100203000AMedicaid
MO202229217Medicaid
MO8583019OtherBC/BS
KS100203000AMedicaid
MOC50731Medicare UPIN