Healthcare Provider Details

I. General information

NPI: 1891300281
Provider Name (Legal Business Name): RIEMER DERMATOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5959 LAWNDALE ST
LUDINGTON MI
49431-2921
US

IV. Provider business mailing address

6785 N HAMLIN SHOALS LN
LUDINGTON MI
49431-8516
US

V. Phone/Fax

Practice location:
  • Phone: 231-268-0302
  • Fax: 405-337-9738
Mailing address:
  • Phone: 616-350-2901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTIE RIEMER
Title or Position: CEO, FOUNDER
Credential: MD
Phone: 616-350-2901