Doctor Name: | JEREMY J. BRAMWELL |
NPI Number: | 1003178666 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 11016723A |
Business Practice Address: | 5230 E Stop 11 Rd Suite 250 Indianapolis, IN - 462376398 |
Business Phone Number: | 3175288921 |
Business Fax Number: | 3175826916 |
Mailing Address: | 5230 E Stop 11 Rd, Suite 250 INDIANAPOLIS |
State: | IN |
Postal Code: | 462376398 |
Phone Number: | 3175288921 |
Fax Number: | 3175826916 |
NPI Enumeration Date: | 06/11/2012 |
NPI Last Update Date: | 06/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 11016723A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |