Provider Demographics
NPI:1871584557
Name:REUTER, NICHOLAS F (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:F
Last Name:REUTER
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 1:1900 CENTRACARE CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-229-4902
Mailing Address - Fax:320-229-5160
Practice Address - Street 1:1900 CENTRACARE CIR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-229-4902
Practice Address - Fax:320-229-5160
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN19979207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
600828OtherARAZ GROUP AMERICAS PPO
COMPOtherONE HEALTH PLAN GREAT WES
HP25507OtherHEALTH PARTNERS
COMPOtherMMSI
0403681OtherMEDICA HEALTH PLANS
110915OtherU CARE
488R2RE PLOtherBLUE CROSS BLUE SHIELD
COMPOtherCHAMPUS
2114067OtherFIRST HEALTH PLAN
6D085REOtherBLUE CROSS BLUE SHIELD
986024OtherPREFERRED ONE
COMPOtherMMSI