Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | OS13580 | FL |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | OS021446 | PA |
NPI | 1487966560 |
---|---|
Provider Name | Christopher William Reb |
First Address | Hershey, PA 17033-2036 |
Second Address | Hershey, PA 17033-2036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 02/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018309600 | (05) | FL |