Provider Demographics
NPI:1083822522
Name:BRAMMER, GLENN M (MD)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:M
Last Name:BRAMMER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-245-7080
Mailing Address - Fax:540-245-7081
Practice Address - Street 1:78 MEDICAL CENTER DR
Practice Address - Street 2:HEART AND VASCULAR CENTER, 2ND FLOOR
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2332
Practice Address - Country:US
Practice Address - Phone:540-245-7080
Practice Address - Fax:540-245-7081
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2011-00493207RC0000X
VA0101254888207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917838Medicaid
NCNC1013AMedicare PIN
NC5917838Medicaid