Provider Demographics
NPI:1316070881
Name:BRAMLETTE, JAMES GLENN SCHWEER (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GLENN SCHWEER
Last Name:BRAMLETTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:GLENN
Other - Last Name:SCHWEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2825 OAK LAWN AVE UNIT 192749
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4688
Mailing Address - Country:US
Mailing Address - Phone:510-683-9500
Mailing Address - Fax:877-880-2039
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:551-996-2200
Practice Address - Fax:201-489-2812
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT668662085R0202X
KY551632085R0202X
CAC531932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0499722Medicaid
NJ479758AVDMedicare PIN
CACA186931Medicare PIN
NJ0499722Medicaid
NJ479758TE0Medicare PIN