Individual
DR. MATTHEW T BRAMLET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 NE GLEN OAK AVE, SUITE 301, PEORIA, IL 61603-3105
(309) 655-3453
(309) 655-3410
Mailing address
420 NE GLEN OAK AVE, SUITE 301, PEORIA, IL 61603-3105
(309) 655-3453
(309) 655-3410
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
036-123369
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216946
MEDICARE GROUP PTAN
IL
Enumeration date
05/22/2008
Last updated
12/27/2010
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