1376682898 NPI number — DONALD E REED MD

Table of content: (NPI 1376682898)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376682898 NPI number — DONALD E REED MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DONALD E REED MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UNION GENERAL SURGICAL ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376682898
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 LONDON AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARYSVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-642-1550
Provider Business Mailing Address Fax Number:
937-578-2821

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
660 LONDON AVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MARYSVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43040-1515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-642-1550
Provider Business Practice Location Address Fax Number:
937-578-2821
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
937-642-1550

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  35-063328 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0122745 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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