Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 4301502826 | MI |
N | 207NS0135X | Procedural Dermatology | 4301502826 | MI |
NPI | 1285098947 |
---|---|
Provider Name | Dr. Christie Riemer |
First Address | Ludington, MI 49431-2921 |
Second Address | Ludington, MI 49431-1917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2016 |
Last Update Date | 08/12/2020 |