Provider Demographics
NPI:1922869056
Name:BREAM MEDICAL
Entity Type:Organization
Organization Name:BREAM MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BREAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-702-0267
Mailing Address - Street 1:6618 LINVILLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-9113
Mailing Address - Country:US
Mailing Address - Phone:252-702-0267
Mailing Address - Fax:336-203-3644
Practice Address - Street 1:721 GROVE ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3339
Practice Address - Country:US
Practice Address - Phone:704-216-1263
Practice Address - Fax:336-203-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty