Provider Demographics
NPI:1538159959
Name:REIMER, ALEXIS B (MD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:B
Last Name:REIMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MAMMOTH RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-4133
Mailing Address - Country:US
Mailing Address - Phone:603-663-8300
Mailing Address - Fax:603-663-8349
Practice Address - Street 1:275 MAMMOTH RD
Practice Address - Street 2:SUITE 2
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-4133
Practice Address - Country:US
Practice Address - Phone:603-663-8300
Practice Address - Fax:603-663-8349
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10878208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH437890OtherCIGNA PIN
NH010878OtherTUFTS PIN
NH12-40980OtherUHC PIN
NH20239YOtherANTHEN REFERRING RAN
NH2329819OtherAETNA PIN
NHNH1839OtherHPHC PIN
NH30200748Medicaid
NHNH1839OtherHPHC PIN
NH437890OtherCIGNA PIN