Provider Demographics
NPI:1831142066
Name:RIEMENSCHNEIDER, BRADLEY JAROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:JAROLD
Last Name:RIEMENSCHNEIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 WHITETAIL CT
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9125
Mailing Address - Country:US
Mailing Address - Phone:330-543-8823
Mailing Address - Fax:330-296-6535
Practice Address - Street 1:1 PERKINS SQ
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1063
Practice Address - Country:US
Practice Address - Phone:330-543-8823
Practice Address - Fax:330-296-6535
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-069893207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000025705OtherANTHEM PROVIDER
OH2040302Medicaid
OHRI0822081Medicare ID - Type Unspecified
OH000000025705OtherANTHEM PROVIDER