Healthcare Provider Details

I. General information

NPI: 1790911683
Provider Name (Legal Business Name): MATTHEW REMAKUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 E 3RD ST
DELTA CO
81416-2815
US

IV. Provider business mailing address

2450 W HUNTING PARK AVE
PHILADELPHIA PA
19129-1302
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-7681
  • Fax:
Mailing address:
  • Phone: 215-728-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD444820
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberCDRH.53833
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: