Provider Demographics
NPI:1164442109
Name:REAUME, JAMES M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:REAUME
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ONTONAGON
Mailing Address - State:MI
Mailing Address - Zip Code:49953-1459
Mailing Address - Country:US
Mailing Address - Phone:906-884-8000
Mailing Address - Fax:906-337-6597
Practice Address - Street 1:601 S 7TH ST
Practice Address - Street 2:
Practice Address - City:ONTONAGON
Practice Address - State:MI
Practice Address - Zip Code:49953-1459
Practice Address - Country:US
Practice Address - Phone:906-884-8000
Practice Address - Fax:906-337-6597
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJR050177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI135697200OtherUS DEPT OF LABOR
MI01349OtherPRIORITY HEALTH PAY TO #
MI104424998Medicaid
MI23-8650OtherRHC CERTIFICATION NUMBER
MI105206868Medicaid
MI383218134OtherTRICARE
MI700C460070OtherBCBS OF MI GROUP PIN
700E260160OtherBCBS OF MI
MI23-8650OtherRHC CERTIFICATION NUMBER
0E26016Medicare PIN
MI700C460070OtherBCBS OF MI GROUP PIN
231822Medicare Oscar/Certification
MI135697200OtherUS DEPT OF LABOR
MI200000001292OtherPHPMM
MI23-8650OtherRHC CERTIFICATION NUMBER
MI700C460070OtherBCBS OF MI GROUP PIN
MI105206868Medicaid
231823Medicare Oscar/Certification
231822Medicare Oscar/Certification