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Individual
MR. JERRY REIMER
Active
Individual
MR. JERRY REIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G81225
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G812250
BLUE CROSS/BLUE SHIELD
CA
05
—
00G812250
—
CA
01
—
77040368493612B013
CHAMPUS
CA
Enumeration date
11/08/2005
Last updated
08/22/2007
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