Ann C Brewer MD Inc

Organization Active NPI Dermatology Physician · Makawao, HI

NPI 1376280669 · NPPES record last updated Feb 8, 2023

Key facts

NPI
1376280669
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
Legal business name
ANN C BREWER MD INC
Practice address
30 Kupaoa St # A207
Makawao, HI 96768-6216
Phone
(808) 207-6563
NPI assigned
May 18, 2022
Organization subpart
No

Authorized official

Name
Ann Brewer, MD
Title
Ceo
Phone
(808) 207-6563

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D2278281Ann C Brewer MD Inc Dba Maui Skin Clinic
30 Kupaoa St A208, Makawao, HI 96768
Provider-performed microscopyMar 13, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in HI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230127001489 HI Part B Supplier - Clinic/Group Practice 7517341167 Receives reassigned benefits from 2 practitioners
Practice locations: Makawao, HI

National Provider Directory

Locations

30 Kupaoa St
Ste 207
Makawao, HI 96768

30 Kupaoa St
#A208
Makawao, HI 96768
Phone (808) 207-6563

30 Kupaoa St
#A207
Makawao, HI 96768
Phone (808) 207-6563

30 Kupaoa St
Ste 208
Makawao, HI 96768
Phone (808) 207-6563

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207N00000X Yes

Addresses

Primary practice location

30 Kupaoa St # A207
Makawao, HI 96768-6216

Mailing address

30 Kupaoa St # A207
Makawao, HI 96768-6216
Phone (808) 207-6563

Other providers in Makawao, HI

All providers in Makawao, HI · Dermatology Physician in Hawaii

Sources for this page

Verify at the official NPI Registry.