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NPI Code Detail

MEDICARE: LOGAN REIMER

MEDICARE: LOGAN REIMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianTL.0006409CO
2207RC0000XCardiovascular Disease PhysicianDR.0064625CO
3207R00000XInternal Medicine PhysicianDR.0064625CO

General Provider Information

NPI Number : 1134653876
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOGAN REIMER
Provider Business Mailing Address
First Line : 605 SCRANTON AVE
Second Line :
City : PUEBLO
State : CO
Zip : 81004-1636
Country : US
Telephone Number : 316-734-8141
Fax Number :
Provider Business Practice Location Address
First Line : 400 W 16TH ST
Second Line :
City : PUEBLO
State : CO
Zip : 81003-2781
Country : US
Telephone Number : 719-584-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2017
Last Update Date : 05/17/2023

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Directions to “ LOGAN REIMER ” Practice Location

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