Provider Demographics
NPI:1700594843
Name:REIMUS, DALTON (PA)
Entity Type:Individual
Prefix:
First Name:DALTON
Middle Name:
Last Name:REIMUS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3713
Mailing Address - Country:US
Mailing Address - Phone:989-793-4250
Mailing Address - Fax:989-793-6880
Practice Address - Street 1:5200 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3713
Practice Address - Country:US
Practice Address - Phone:989-793-4250
Practice Address - Fax:989-793-6880
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical