Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 01067300A | IN |
N | 208600000X | Surgeon | 01067300A | IN |
N | 208200000X | Surgeon | 36098271 | IL |
N | 208600000X | Surgeon | 36098271 | IL |
Y | 2086S0102X | Surgical Critical Care | 01067300A | IN |
N | 2086S0102X | Surgical Critical Care | 36098271 | IL |
NPI | 1235105354 |
---|---|
Provider Name | Dr. Robert Lawrence Reed II |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 20/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000636165 | ANTHEM PIN (01) | IN |
200853250 | (05) | IN |
C20937 | (02) |