Provider Demographics
NPI:1609952530
Name:BRAMMER, DAVID DEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DEAN
Last Name:BRAMMER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:414 HUNGERFORD DR
Mailing Address - Street 2:#100
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4125
Mailing Address - Country:US
Mailing Address - Phone:301-762-2223
Mailing Address - Fax:301-762-1075
Practice Address - Street 1:414 HUNGERFORD DR
Practice Address - Street 2:#100
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4125
Practice Address - Country:US
Practice Address - Phone:301-762-2223
Practice Address - Fax:301-762-1075
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0936152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU35916Medicare UPIN