# BREMEN FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003023987
- **Authorized official:** REGINA L HOLLOWAY MD (OWNER)
- **Authorized official phone:** (770) 537-1960

## Contact information

- **Practice address:** 308 CARROLLTON ST, BREMEN, GA 30110-2015
- **Practice address phone:** (770) 537-1960
- **Practice address fax:** (770) 537-1901
- **Mailing address:** 327 OLD BUSHMILL RD, BREMEN, GA 30110-3835
- **Mailing address phone:** (770) 537-1960
- **Mailing address fax:** (770) 537-1901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 034852 | GA | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00478552H | — | GA |