Healthcare Provider Details

I. General information

NPI: 1124057906
Provider Name (Legal Business Name): REMINGTON LEE NEVIN MD, MPH, DRPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 09/11/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C/O EDA OF ST CLAIR COUNTY 100 MCMORRAN BLVD FL 5
PORT HURON MI
48060
US

IV. Provider business mailing address

C/O EDA OF ST CLAIR COUNTY 100 MCMORRAN BLVD FL 5
PORT HURON MI
48060-4021
US

V. Phone/Fax

Practice location:
  • Phone: 810-276-1657
  • Fax:
Mailing address:
  • Phone: 810-276-1657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number4301509878
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number4301509878
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: