Healthcare Provider Details

I. General information

NPI: 1629572888
Provider Name (Legal Business Name): JOEL REIMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18230 E SILVER CREEK AVE
BUCKLEY AFB CO
80011-9501
US

IV. Provider business mailing address

18230 E SILVER CREEK AVE
BUCKLEY AFB CO
80011-9501
US

V. Phone/Fax

Practice location:
  • Phone: 720-847-6486
  • Fax:
Mailing address:
  • Phone: 720-847-6486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101267945
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: