Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 42995 | KY |
N | 207RI0200X | Infectious Disease | 7463 | AL |
NPI | 1063458156 |
---|---|
Provider Name | Michael T Reymann |
First Address | Lexington, KY 40503-1404 |
Second Address | Lexington, KY 40503-1404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 30/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000627333 | BLUE CROSS & BLUE SHIELD (01) | KY |
009965520 | (05) | AL |
51001925 | BLUE CROSS BLUE SHIELD (01) | AL |
7100082760 | (05) | KY |
C73967 | (02) | AL |