Provider Demographics
NPI:1851542591
Name:BREWER, CHARLES HUDDLESTON JR (MD)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:HUDDLESTON
Last Name:BREWER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:121 INTERSTATE BLVD
Mailing Address - Street 2:UNIT 2 A
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615
Mailing Address - Country:US
Mailing Address - Phone:864-297-4275
Mailing Address - Fax:864-297-4277
Practice Address - Street 1:121 INTERSTATE BLVD
Practice Address - Street 2:UNIT 2 A
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615
Practice Address - Country:US
Practice Address - Phone:864-297-4275
Practice Address - Fax:864-297-4277
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCSC147092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry