Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 4301046162 | MI |
N | 208000000X | Pediatrician | 4301046162 | MI |
NPI | 1033170949 |
---|---|
Provider Name | Gary Andrew Reinheimer |
First Address | Clinton Twp, MI 48038-1135 |
Second Address | Chesterfield, MI 48047-5720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 18/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4373674 | (05) | MI |
4373807 | (05) | MI |
4704131 | (05) | MI |
B48583 | (02) | MI |