Provider Demographics
NPI:1225204118
Name:STEVEN D RIMAR MD PC
Entity Type:Organization
Organization Name:STEVEN D RIMAR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:CRADDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-267-5005
Mailing Address - Street 1:4600 INVESTMENT DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6365
Mailing Address - Country:US
Mailing Address - Phone:248-267-5005
Mailing Address - Fax:248-267-5006
Practice Address - Street 1:4600 INVESTMENT DR
Practice Address - Street 2:SUITE 250
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-6365
Practice Address - Country:US
Practice Address - Phone:248-267-5005
Practice Address - Fax:248-267-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISR0485822086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104255830Medicaid
MI0N11920Medicare PIN
MI104255830Medicaid