| Relymd Medical Group | |
|
1920 Thomes Ave Ste 610 Cheyenne WY 82001-3548 | |
| (919) 932-0928 | |
| Not Available |
| Full Name | Relymd Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1920 Thomes Ave Ste 610, Cheyenne, Wyoming |
| Authorized Official Name and Position | Ronald Michael Creatore (CFO) |
| Authorized Official Contact | 9199320928 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Relymd Medical Group 510 Meadowmont Village Cir Ste 323 Chapel Hill NC 27517-7584 Ph: (919) 932-0928 | Relymd Medical Group 1920 Thomes Ave Ste 610 Cheyenne WY 82001-3548 Ph: (919) 932-0928 |
| NPI Number | 1639781875 |
|---|---|
| Provider Enumeration Date | 08/19/2020 |
| Last Update Date | 10/18/2020 |
| Medicare PECOS PAC ID | 3779986617 |
|---|---|
| Medicare Enrollment ID | O20210729001337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639781875 | NPI | - | NPPES |
| 2020-000937164 | Other | WY | WYOMING SECRETARY OF STATE IDENTIFICATION NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert Park |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124121348 PECOS PAC ID: 1557390267 Enrollment ID: I20210818001694 |
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