Provider Demographics
NPI:1255326211
Name:REAM, TODD L (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:L
Last Name:REAM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2490 S 11TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-2175
Mailing Address - Country:US
Mailing Address - Phone:269-343-1535
Mailing Address - Fax:269-343-0418
Practice Address - Street 1:2490 S 11TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2175
Practice Address - Country:US
Practice Address - Phone:269-343-1535
Practice Address - Fax:269-343-0418
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
MI065684207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4208311Medicaid
MIH24270Medicare UPIN