Provider Demographics
NPI:1255389581
Name:HEALTH DYNAMICS, LLC
Entity type:Organization
Organization Name:HEALTH DYNAMICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:REMINGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-290-6700
Mailing Address - Street 1:1522 N PROSPECT AVE UNIT 1302
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-6525
Mailing Address - Country:US
Mailing Address - Phone:414-573-0007
Mailing Address - Fax:414-290-6755
Practice Address - Street 1:1522 N PROSPECT AVE UNIT 1302
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-6525
Practice Address - Country:US
Practice Address - Phone:414-573-0007
Practice Address - Fax:414-290-6755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI=========019OtherBCBS OF WISCONSIN
WI=========019OtherBCBS OF WISCONSIN