Healthcare Provider Details

I. General information

NPI: 1043312796
Provider Name (Legal Business Name): DAV WILLIAM BREMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E ALEX BELL RD
CENTERVILLE FINANCE OH
45459-2687
US

IV. Provider business mailing address

1201 E ALEX BELL RD
CENTERVILLE FINANCE OH
45459-2687
US

V. Phone/Fax

Practice location:
  • Phone: 937-433-9082
  • Fax: 937-433-2994
Mailing address:
  • Phone: 937-433-9082
  • Fax: 937-433-2994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number047246
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: