Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD.204777 | LA |
N | 208200000X | Surgeon | 036.118076 | IL |
N | 208600000X | Surgeon | 036.118076 | IL |
NPI | 1104092899 |
---|---|
Provider Name | Dr. Trevor William Reichman |
First Address | New Orleans, LA 70121-2429 |
Second Address | New Orleans, LA 70121-2429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2008 |
Last Update Date | 05/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
09888292 | (05) | MS |
2158724 | (05) | LA |