Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2007-00568 | NC |
N | 111NI0900X | Internist | 2007-00568 | NC |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 2007-00568 | NC |
N | 207RC0000X | Internist - Cardiovascular Disease | 2007-00568 | NC |
N | 207RC0000X | Internist - Cardiovascular Disease | MD434416 | PA |
NPI | 1760687552 |
---|---|
Provider Name | Dr. Gordon Reginald Reeves |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0308234 | (05) | NJ |
1027229750001 | (05) | PA |