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NPI Code Detail

MEDICARE: SUSHAMA S BRIMMER MD

MEDICARE: SUSHAMA S BRIMMER 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
1207R00000XInternal Medicine PhysicianL6808TX

General Provider Information

NPI Number : 1184629990
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSHAMA S BRIMMER MD
Provider Business Mailing Address
First Line : PO BOX 4207
Second Line :
City : LONGVIEW
State : TX
Zip : 75606-4207
Country : US
Telephone Number : 903-315-1488
Fax Number : 903-315-1656
Provider Business Practice Location Address
First Line : 700 E MARSHALL AVE
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5580
Country : US
Telephone Number : 903-315-1488
Fax Number : 903-315-1656
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 01/02/2014

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Directions to “ SUSHAMA S BRIMMER MD” Practice Location

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