MEDICARE: BRANDON FOREMAN MD MS

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	35123995	OH
2	2084N0400X	Neurology Physician	262007	NY
3	2084N0400X	Neurology Physician	35123995	OH

General Provider Information

NPI Number	:	1477748382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON FOREMAN MD MS

Provider Business Mailing Address
First Line	:	3113 BELLEVUE AVE FL 3
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-3158
Country	:	US
Telephone Number	:	513-475-8730
Fax Number	:	513-475-8033

Provider Business Practice Location Address
First Line	:	3113 BELLEVUE AVE FL 3
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-3158
Country	:	US
Telephone Number	:	513-475-8730
Fax Number	:	513-475-8033

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

Provider Enumeration Date	:	09/13/2007
Last Update Date	:	03/17/2021

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