Provider Demographics
NPI:1043453111
Name:REIMER, NICKOLAS BERNARD (MD)
Entity type:Individual
Prefix:DR
First Name:NICKOLAS
Middle Name:BERNARD
Last Name:REIMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HOWARD FARM DR STE 305
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6075
Mailing Address - Country:US
Mailing Address - Phone:404-847-4230
Mailing Address - Fax:404-847-4232
Practice Address - Street 1:2000 HOWARD FARM DR STE 305
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6075
Practice Address - Country:US
Practice Address - Phone:404-847-4230
Practice Address - Fax:404-847-4232
Is Sole Proprietor?:No
Enumeration Date:2009-04-19
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA069245207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program