Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD16666 | RI |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 86546 | SC |
NPI | 1205249216 |
---|---|
Provider Name | Daniel B.c. Reid |
First Address | Conway, SC 29526-9142 |
Second Address | Conway, SC 29526-8945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2014 |
Last Update Date | 16/09/2021 |