Provider Demographics
NPI:1861457285
Name:REITELMAN, CLAUDE (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:
Last Name:REITELMAN
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 1:263 PURITAN AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-4631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:263 PURITAN AVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-4631
Practice Address - Country:US
Practice Address - Phone:248-258-2831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010507232088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI01004180OtherHEALTH PLUS
MI103195OtherPRIORITY HEALTH
MI4466562OtherAETNA
MI01004180OtherHEALTH PLUS
MIB49331Medicare UPIN
MI0E06273013Medicare PIN
MI0219690001Medicare NSC
MI340010642OtherRAILROAD MEDICARE
MIB49331OtherHAP