Healthcare Provider Details

I. General information

NPI: 1699715805
Provider Name (Legal Business Name): RICHARD ALAN BREMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 LAUREL RIDGE DR
WAYNESVILLE NC
28786-9160
US

IV. Provider business mailing address

400 LAUREL RIDGE DR
WAYNESVILLE NC
28786-9160
US

V. Phone/Fax

Practice location:
  • Phone: 828-452-1683
  • Fax: 828-452-1760
Mailing address:
  • Phone: 828-452-1683
  • Fax: 828-452-1760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number30008
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: