Provider Demographics
NPI:1922041144
Name:BRAMEL, JENE E III (MD)
Entity Type:Individual
Prefix:DR
First Name:JENE
Middle Name:E
Last Name:BRAMEL
Suffix:III
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 1:204 PATRICK AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-2302
Mailing Address - Country:US
Mailing Address - Phone:937-484-6157
Mailing Address - Fax:937-484-6181
Practice Address - Street 1:204 PATRICK AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-2302
Practice Address - Country:US
Practice Address - Phone:937-484-6157
Practice Address - Fax:937-484-6181
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.080841208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2347919Medicaid
OHH345820Medicare PIN