Provider Demographics
NPI:1245441955
Name:BREWER, ERIN ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ELIZABETH
Last Name:BREWER
Suffix:
Gender:F
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 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:504-443-9520
Practice Address - Street 1:2120 DRIFTWOOD BLVD.
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3574
Practice Address - Country:US
Practice Address - Phone:504-443-9500
Practice Address - Fax:504-443-9520
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.13403R207Q00000X
LA13403207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1104680Medicaid
MS00437059Medicaid
LA1104680Medicaid