Provider Demographics
NPI:1891987517
Name:BREWSTER, FREDERICK B
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:B
Last Name:BREWSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 2ND AVE
Mailing Address - Street 2:SUITE 307B
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3360
Mailing Address - Country:US
Mailing Address - Phone:301-565-2002
Mailing Address - Fax:
Practice Address - Street 1:8609 2ND AVE
Practice Address - Street 2:SUITE 307B
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3360
Practice Address - Country:US
Practice Address - Phone:301-565-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD035101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD661985Medicare PIN