Provider Demographics
NPI:1871539502
Name:BREWER, RAYMOND MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:MICHAEL
Last Name:BREWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 RESERVE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-3101
Mailing Address - Country:US
Mailing Address - Phone:931-499-7244
Mailing Address - Fax:931-499-7243
Practice Address - Street 1:3001 RESERVE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-3101
Practice Address - Country:US
Practice Address - Phone:931-499-7244
Practice Address - Fax:931-499-7243
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD000017994207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2616061010OtherCIGNA HMO
TN3037751OtherACCESS
TN3157268OtherBC/BS BLUECARE
MS117782Medicaid
TN2616061004OtherCIGNA POS
TN3037751Medicaid
TN621298528OtherBAPTIST & PHYSICIANS
TN4101742OtherAETNA PPO
TN3037751OtherACCESS
TN621298528OtherBAPTIST & PHYSICIANS
TN3037751Medicaid