Provider Demographics
NPI:1821889023
Name:MREMA, GILBERT S
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:S
Last Name:MREMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4522 BLUESTEM CT S UNIT F
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4303
Mailing Address - Country:US
Mailing Address - Phone:701-729-5178
Mailing Address - Fax:
Practice Address - Street 1:4522 BLUESTEM CT S UNIT F
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4303
Practice Address - Country:US
Practice Address - Phone:701-729-5178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDNDL212100342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company