Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 0422266KS | KS |
Y | 207RN0300X | Nephrologist | R9E62MO | MO |
NPI | 1013984731 |
---|---|
Provider Name | Dr. Gerald M Reid |
First Address | Kansas City, MO 64131 |
Second Address | Kansas City, MO 64131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 03/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202142311 | (05) | MO |
C51001 | (02) |