Provider Demographics
NPI:1609077023
Name:BREWER LITTLEJOHN, ROBYN BETRICE (MD)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:BETRICE
Last Name:BREWER LITTLEJOHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 CAMERON VALLEY PKWY STE 3100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4377
Mailing Address - Country:US
Mailing Address - Phone:704-355-5100
Mailing Address - Fax:704-355-5186
Practice Address - Street 1:4525 CAMERON VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4369
Practice Address - Country:US
Practice Address - Phone:704-355-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00330207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNC1275Medicaid
NC5916116Medicaid
NC1609077023Medicaid
NC1609077023Medicaid
SCNC1275Medicaid