Provider Demographics
NPI:1689620122
Name:REINHEIMER, BRENT (MD)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:REINHEIMER
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:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833
Mailing Address - Country:US
Mailing Address - Phone:603-580-7525
Mailing Address - Fax:603-580-7542
Practice Address - Street 1:5 ALUMNI DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833
Practice Address - Country:US
Practice Address - Phone:603-580-7525
Practice Address - Fax:603-580-7542
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13003207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30206112Medicaid
NH01Y009995NH01OtherANTHEM BCBS
NHH66194Medicare UPIN
NH30206112Medicaid