Provider Demographics
NPI:1356503122
Name:REMUS REPTA MD PLLC
Entity Type:Organization
Organization Name:REMUS REPTA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEAGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLMSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-377-3782
Mailing Address - Street 1:3271 N CIVIC CENTER PLZ STE 105
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6990
Mailing Address - Country:US
Mailing Address - Phone:855-377-3782
Mailing Address - Fax:928-268-3517
Practice Address - Street 1:3271 N CIVIC CENTER PLZ STE 105
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6990
Practice Address - Country:US
Practice Address - Phone:855-377-3782
Practice Address - Fax:928-268-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ379782086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty