Provider Demographics
NPI:1467420513
Name:KREMER, REINER GOTTHARD (DC, NMD, MPAS, PA-C)
Entity Type:Individual
Prefix:DR
First Name:REINER
Middle Name:GOTTHARD
Last Name:KREMER
Suffix:
Gender:M
Credentials:DC, NMD, MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80116-0011
Mailing Address - Country:US
Mailing Address - Phone:303-688-1111
Mailing Address - Fax:720-459-7019
Practice Address - Street 1:7601 BURNING TREE DR
Practice Address - Street 2:
Practice Address - City:FRANKTOWN
Practice Address - State:CO
Practice Address - Zip Code:80116-9503
Practice Address - Country:US
Practice Address - Phone:303-688-1111
Practice Address - Fax:720-459-7019
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1281111N00000X
AZ07-988175F00000X
COPA0003980363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No111N00000XChiropractic ProvidersChiropractor
No175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
COT60443Medicare UPIN
COCK0613Medicare PIN