Provider Demographics
NPI:1598877029
Name:BREWER, SHERRY RODDY (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:RODDY
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 1:2151 MEETING ST APT 5206
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-4648
Mailing Address - Country:US
Mailing Address - Phone:563-508-7156
Mailing Address - Fax:
Practice Address - Street 1:2 MIRANOVA PL STE 500
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-7052
Practice Address - Country:US
Practice Address - Phone:614-321-9743
Practice Address - Fax:614-675-9303
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33243207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN