Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 35-02-6773-R | OH |
NPI | 1386620540 |
---|---|
Provider Name | David George Reed |
First Address | Youngstown, OH 44512-7333 |
Second Address | Youngstown, OH 44512-7333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 17/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0458973 | (05) | OH |
B96550 | (02) |