Provider Demographics
NPI:1629055934
Name:BREWINGTON, THOMAS E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:BREWINGTON
Suffix:JR
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 1:807 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7833
Mailing Address - Country:US
Mailing Address - Phone:336-272-5628
Mailing Address - Fax:336-273-1671
Practice Address - Street 1:807 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7833
Practice Address - Country:US
Practice Address - Phone:336-272-5628
Practice Address - Fax:336-273-1671
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17620207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8918237Medicaid
NC18237OtherBCBS
NC0628160001OtherDMERC
NC18237OtherBCBS
NCC80822Medicare UPIN