Provider Demographics
NPI:1801885470
Name:REMER, ELSA MARIA (MD)
Entity type:Individual
Prefix:
First Name:ELSA
Middle Name:MARIA
Last Name:REMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:400 E BROADWAY AVE
Mailing Address - Street 2:STE 306
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4038
Mailing Address - Country:US
Mailing Address - Phone:701-323-9500
Mailing Address - Fax:701-323-9501
Practice Address - Street 1:400 E BROADWAY AVE
Practice Address - Street 2:STE 306
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4038
Practice Address - Country:US
Practice Address - Phone:701-323-9500
Practice Address - Fax:701-323-9501
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND57612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND16622Medicaid
E73915Medicare UPIN
ND22766Medicare ID - Type Unspecified