1861570111 NPI number — JOHN A. BREM, DPM

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861570111 NPI number — JOHN A. BREM, DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN A. BREM, DPM
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861570111
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 MARKET ST
Provider Second Line Business Mailing Address:
SUITE 802
Provider Business Mailing Address City Name:
STEUBENVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43952-2881
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-282-0861
Provider Business Mailing Address Fax Number:
740-282-7002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 802
Provider Business Practice Location Address City Name:
STEUBENVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43952-2881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-282-0861
Provider Business Practice Location Address Fax Number:
740-282-7002
Provider Enumeration Date:
11/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BREM
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
DPM
Authorized Official Telephone Number:
740-282-0861

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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