Basic Information
Provider Information
NPI: 1326139593
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BREWER
FirstName: UNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 LINDENWOOD DRIVE
Address2: SUITE 350
City: MALVERN
State: PA
PostalCode: 19355
CountryCode: US
TelephoneNumber: 2155902897
FaxNumber: 2155900325
Practice Location
Address1: 1766 WILMINGTON PIKE
Address2:  
City: GLEN MILLS
State: PA
PostalCode: 19342
CountryCode: US
TelephoneNumber: 6103582778
FaxNumber: 6103583508
Other Information
ProviderEnumerationDate: 09/27/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XMD 050424PAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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