Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | ME0069157 | FL |
N | 207R00000X | Internist | ME0069157 | FL |
N | 111NI0900X | Internist | ME0069157 | FL |
N | 208000000X | Pediatrician | ME0069157 | FL |
N | 2080P0204X | Pediatric Emergency Doctor | ME0069157 | FL |
NPI | 1265522361 |
---|---|
Provider Name | Dr. Charles D Reed |
First Address | Palm City, FL 34990-6046 |
Second Address | Palm City, FL 34990-6046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |