MEDICARE: CHARLES B BRIMMER DO

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	207L00000X	Anesthesiology Physician	02008413A	IN
2	207R00000X	Internal Medicine Physician	R3803	AZ

General Provider Information

NPI Number	:	1124778550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES B BRIMMER DO

Provider Business Mailing Address
First Line	:	1130 W MICHIGAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5209
Country	:	US
Telephone Number	:	317-274-0076
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 W. MICHIGAN STREET
Second Line	:	FESLER HALL 204
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5209
Country	:	US
Telephone Number	:	317-274-0076
Fax Number	:

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

Provider Enumeration Date	:	03/28/2022
Last Update Date	:	06/04/2026

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Directions to “ CHARLES B BRIMMER DO” Practice Location

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