Provider Demographics
NPI:1659604197
Name:BREWER, THOMAS FORDHAM (MD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:FORDHAM
Last Name:BREWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:SC
Mailing Address - Zip Code:29388-8428
Mailing Address - Country:US
Mailing Address - Phone:859-721-1414
Mailing Address - Fax:888-965-5113
Practice Address - Street 1:613 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:SC
Practice Address - Zip Code:29388-8428
Practice Address - Country:US
Practice Address - Phone:859-721-1414
Practice Address - Fax:888-965-5113
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY355872083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine