Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 24729 | NE |
NPI | 1609041235 |
---|---|
Provider Name | Dr. Adam Lewis Reinhardt |
First Address | Boys Town, NE 68010-4113 |
Second Address | Boys Town, NE 68010-4113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2008 |
Last Update Date | 09/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025126700 | (05) | NE |
1609041235 | (05) | IA |