Bruce Robert Reames Jr., PA-C
Individual provider Active NPI Physician Assistant · Edmore, MI
NPI 1366532244 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1366532244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601001291 (MI)
- Practice address
- 1131 E Howard City Edmore Rd
Edmore, MI 48829-9737 - Phone
- (989) 427-5070
- Fax
- (989) 427-3690
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601001291 | MI | Yes |
Addresses
Primary practice location
1131 E Howard City Edmore Rd
Edmore, MI 48829-9737
Mailing address
4500 W Howard City Edmore Rd
Six Lakes, MI 48886-9739
Phone (989) 814-0627
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102970 | Medicaid | MI |
Other providers in Edmore, MI
- Cortney Jean Nemeth
- Andrea Obrien
- Charles Odonald
- Kaitlin Beth Papendick
- Premier Nursing Care, Inc
- Prakash Sarvepalli
- Sailaja Sarvepalli
All providers in Edmore, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.