Provider Demographics
NPI:1144277567
Name:REUWER, JOHN F (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:REUWER
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 1:150 DORSET ST STE 245-353
Mailing Address - Street 2:
Mailing Address - City:S BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6256
Mailing Address - Country:US
Mailing Address - Phone:540-267-4317
Mailing Address - Fax:
Practice Address - Street 1:7 FAYETTE DR
Practice Address - Street 2:
Practice Address - City:S BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6977
Practice Address - Country:US
Practice Address - Phone:802-658-5756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034346207P00000X
VT042-0012059207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010041309Medicaid
VA010041309Medicaid
B59616Medicare UPIN