Individual
DR. THOMAS K BREDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3205 PEMBROKE SQ, JEFFERSON CITY, MO 65109-5731
(573) 690-5665
Mailing address
3205 PEMBROKE SQ, JEFFERSON CITY, MO 65109-5731
(573) 690-5665
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36582
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246894406
—
MO
01
—
32232
BNDD
MO
Enumeration date
05/23/2005
Last updated
03/07/2023
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