Provider Demographics
NPI:1689635922
Name:NIMER, LYNN R (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:R
Last Name:NIMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1055 N 500 W
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3305
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:801-418-0941
Practice Address - Street 1:1380 E MEDICAL CENTER DR STE 4100
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2156
Practice Address - Country:US
Practice Address - Phone:435-251-2900
Practice Address - Fax:435-251-2901
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT178780-1205207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTF81970Medicare UPIN
UT000011708Medicare ID - Type Unspecified