Healthcare Provider Details

I. General information

NPI: 1396206488
Provider Name (Legal Business Name): LISA MARIE REIMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 FEDERAL ST
LYNCHBURG VA
24504-2306
US

IV. Provider business mailing address

134 ELON RD
MADISON HEIGHTS VA
24572-2536
US

V. Phone/Fax

Practice location:
  • Phone: 434-455-2480
  • Fax:
Mailing address:
  • Phone: --
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0065432
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101278893
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: