Provider Demographics
NPI:1336133487
Name:REITER, ROSEMARY K (MD)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:K
Last Name:REITER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:419-782-8332
Mailing Address - Fax:419-782-6855
Practice Address - Street 1:1250 RALSTON AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-5311
Practice Address - Country:US
Practice Address - Phone:419-782-8332
Practice Address - Fax:419-782-6855
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35082506207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH23-37377OtherUHC
OH000000303343OtherANTHEM
OH04370OtherPHC
OH2417218Medicaid
OH7544565OtherAETNA
OHP00038305OtherRRMC
OHP00038305OtherRRMC
OH7544565OtherAETNA