Provider Demographics
NPI:1821297185
Name:REIMER, BRETT JEFFREY (DO)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:JEFFREY
Last Name:REIMER
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 1:1105 N ANKENY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4003
Mailing Address - Country:US
Mailing Address - Phone:515-964-4600
Mailing Address - Fax:515-963-4142
Practice Address - Street 1:1105 N ANKENY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4003
Practice Address - Country:US
Practice Address - Phone:515-964-4600
Practice Address - Fax:515-963-4142
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-03822207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1821297185Medicaid
IA0200735Medicaid
IA1821297185Medicaid
IAI20918Medicare PIN