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NPI Code Detail

MEDICARE: KENT D BREAM MD

MEDICARE: KENT D BREAM MD
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
1207Q00000XFamily Medicine PhysicianMD059643LPA

Other Identifiers

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

General Provider Information

NPI Number : 1538196423
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENT D BREAM MD
Provider Business Mailing Address
First Line : 5800 WALNUT ST REAR
Second Line : FAMILY MEDICINE & COMMUNITY HEALTH
City : PHILADELPHIA
State : PA
Zip : 19139-3836
Country : US
Telephone Number : 215-474-4444
Fax Number :
Provider Business Practice Location Address
First Line : 5800 WALNUT ST REAR
Second Line : FAMILY MEDICINE & COMMUNITY HEALTH
City : PHILADELPHIA
State : PA
Zip : 19139-3836
Country : US
Telephone Number : 215-474-4444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 09/16/2015

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Directions to “ KENT D BREAM MD” Practice Location

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