Provider Demographics
NPI:1558446831
Name:BRAM, ARTHUR A (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:A
Last Name:BRAM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22472 SHORE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123
Mailing Address - Country:US
Mailing Address - Phone:216-261-1900
Mailing Address - Fax:216-261-1163
Practice Address - Street 1:22472 SHORE CENTER DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123
Practice Address - Country:US
Practice Address - Phone:216-261-1900
Practice Address - Fax:216-261-1163
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2903T371152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0247665Medicaid
OHH354430Medicare PIN
OH0398332Medicare PIN