Provider Demographics
NPI:1629504212
Name:BREWERMD PLLC
Entity Type:Organization
Organization Name:BREWERMD PLLC
Other - Org Name:HONEST WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:RODDY
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-259-7269
Mailing Address - Street 1:5014 WYNDHAM CT
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-5390
Mailing Address - Country:US
Mailing Address - Phone:563-259-7269
Mailing Address - Fax:844-246-6378
Practice Address - Street 1:2435 KIMBERLY RD
Practice Address - Street 2:96 SOUTH
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3509
Practice Address - Country:US
Practice Address - Phone:563-259-7269
Practice Address - Fax:844-246-6378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA41467261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center