Provider Demographics
NPI:1912285230
Name:REIMER, SEAN CLIFFORD (MD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:CLIFFORD
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 1:53 STATE ST STE B
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1981
Mailing Address - Country:US
Mailing Address - Phone:330-729-8960
Mailing Address - Fax:330-729-1861
Practice Address - Street 1:53 STATE ST STE B
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1981
Practice Address - Country:US
Practice Address - Phone:330-729-8960
Practice Address - Fax:330-729-1861
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.127378208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0170810Medicaid