Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 36150 | SC |
Y | 208600000X | Surgeon | 36150 | SC |
N | 208200000X | Surgeon | 58471 | NC |
N | 208600000X | Surgeon | 58471 | NC |
N | 2082S0105X | Plastic Hand Surgeon | 36150 | SC |
N | 2086S0105X | Surgery of the Hand | 036.118809 | IL |
N | 2086S0122X | Plastic and Reconstructive Surgery | 036.118809 | IL |
N | 2086S0122X | Plastic and Reconstructive Surgery | 58471 | NC |
NPI | 1497755805 |
---|---|
Provider Name | Dr. David S. Reid IV |
First Address | Hilton Head, SC 29926-2731 |
Second Address | Hilton Head, SC 29926-2731 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 16/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8971096 | (05) | NC |
E43670 | (02) | NC |