1750611570 NPI number — JOSEPH A REINHARDT MD PA

Table of content: (NPI 1750611570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750611570 NPI number — JOSEPH A REINHARDT MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOSEPH A REINHARDT MD PA
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:
Provider Other Organization Name Type Code:
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:
1750611570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2003 ROCK SPRING RD
Provider Second Line Business Mailing Address:
#7
Provider Business Mailing Address City Name:
FOREST HILL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21050-2611
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-879-4590
Provider Business Mailing Address Fax Number:
410-420-1602

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2003 ROCK SPRING RD
Provider Second Line Business Practice Location Address:
#7
Provider Business Practice Location Address City Name:
FOREST HILL
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21050-2611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-879-4590
Provider Business Practice Location Address Fax Number:
410-420-1602
Provider Enumeration Date:
12/29/2009

Additional Information

Authorized Official

Authorized Official Last Name:
REINHARDT
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER/PHYSCIAN
Authorized Official Telephone Number:
410-879-4590

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D0015673 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7011JA . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 18837 1200 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: R3850001 . This is a "BLUE CROSS BLUE SHIELD FEDERAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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