Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME126410 | FL |
N | 208600000X | Surgeon | ME126410 | FL |
Y | 2086S0120X | Pediatric Surgery | C10007408 | DE |
N | 2086S0120X | Pediatric Surgery | MD056010L | PA |
N | 2086S0120X | Pediatric Surgery | ME126410 | FL |
NPI | 1063504801 |
---|---|
Provider Name | Dr. Kirk W. Reichard |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 13/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001864249 | (05) | PA |
0050717 | (05) | NJ |
0594531 | (05) | IA |
4516001 | (05) | MD |
I14631 | (02) | |
KR68133 | (05) | RI |