Provider Demographics
NPI:1285657460
Name:BREM, JOHN A (DPM)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:BREM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:401 MARKET STREET
Mailing Address - Street 2:SUITE 802
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952
Mailing Address - Country:US
Mailing Address - Phone:740-282-0861
Mailing Address - Fax:740-282-7002
Practice Address - Street 1:401 MARKET STREET
Practice Address - Street 2:SUITE 802
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952
Practice Address - Country:US
Practice Address - Phone:740-282-0861
Practice Address - Fax:740-282-7002
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV00376213E00000X
OH36003211213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2373588Medicaid
OH5059690001Medicare NSC
OH2373588Medicaid
OHBR4095901Medicare PIN