Provider Demographics
NPI:1336274570
Name:REIMERS, CHARLES E (PAC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:REIMERS
Suffix:
Gender:M
Credentials:PAC
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Mailing Address - Street 1:C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT
Mailing Address - Street 2:PO BOX 7291
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-7291
Mailing Address - Country:US
Mailing Address - Phone:207-777-8941
Mailing Address - Fax:207-777-8800
Practice Address - Street 1:360 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3979
Practice Address - Country:US
Practice Address - Phone:207-907-3000
Practice Address - Fax:207-907-1921
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2021-05-05
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Provider Licenses
StateLicense IDTaxonomies
MEPA1596363A00000X
NC0010-00829363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant