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NPI Code Detail

MEDICARE: JOSEPH W BREMER MD

MEDICARE: JOSEPH W BREMER 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
1207Y00000XOtolaryngology Physician01036605AIN

General Provider Information

NPI Number : 1982672036
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH W BREMER MD
Provider Business Mailing Address
First Line : PO BOX 5545
Second Line :
City : LAFAYETTE
State : IN
Zip : 47903-5545
Country : US
Telephone Number : 765-448-8000
Fax Number :
Provider Business Practice Location Address
First Line : 2600 GREENBUSH ST
Second Line :
City : LAFAYETTE
State : IN
Zip : 47904-2479
Country : US
Telephone Number : 765-448-8000
Fax Number : 765-448-7625
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 11/20/2018

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