MEDICARE: CELESTEANN BREMER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	0101102565	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144213026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELESTEANN BREMER M.D.

Provider Business Mailing Address
First Line	:	5900 LAKE WRIGHT DR
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-1871
Country	:	US
Telephone Number	:	757-466-8683
Fax Number	:	757-466-8892

Provider Business Practice Location Address
First Line	:	1950 GLENN MITCHELL DR
Second Line	:	SUITE 102
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-0019
Country	:	US
Telephone Number	:	757-368-0437
Fax Number	:	757-368-0492

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	09/22/2014

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