Provider Demographics
NPI:1710975347
Name:TREIMER, TODD A (DO)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:TREIMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-3421
Mailing Address - Country:US
Mailing Address - Phone:641-828-3832
Mailing Address - Fax:
Practice Address - Street 1:1208 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-3421
Practice Address - Country:US
Practice Address - Phone:641-828-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
51002983OtherBLUE CROSS
AL009969670Medicaid
AL009969670Medicaid
F93248Medicare UPIN
AL051504186Medicare ID - Type Unspecified