Provider Demographics
NPI:1518923721
Name:NEMER, RAYMOND G (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:G
Last Name:NEMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 WHITTECAR AVE
Mailing Address - Street 2:
Mailing Address - City:GREGORY
Mailing Address - State:SD
Mailing Address - Zip Code:57533-1340
Mailing Address - Country:US
Mailing Address - Phone:605-835-9611
Mailing Address - Fax:605-835-8033
Practice Address - Street 1:405 WHITTECAR AVE
Practice Address - Street 2:
Practice Address - City:GREGORY
Practice Address - State:SD
Practice Address - Zip Code:57533-1340
Practice Address - Country:US
Practice Address - Phone:605-835-9611
Practice Address - Fax:605-835-8033
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0534207Q00000X
NE10323207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0000028OtherWELLMARK BC/BS GROUP #
NE46022474312Medicaid
SD0534OtherDAKOTACARE
SD5601643Medicaid
SDD25498Medicare UPIN
SD5601643Medicaid
SD0000028OtherWELLMARK BC/BS GROUP #
SDS28Medicare PIN