Individual
RANDOLPH G REIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W SOUTH BOULDER RD, SUITE 214, LAFAYETTE, CO 80026-2752
(303) 604-4660
(303) 604-4662
Mailing address
5450 WESTERN AVE, SUITE B, BOULDER, CO 80301-2709
(303) 415-4770
(303) 415-4769
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30677
CO
208100000X
Physical Medicine & Rehabilitation Physician
30677
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01306778
—
CO
Enumeration date
09/19/2006
Last updated
11/10/2015
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