Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D64593 | MD |
Y | 208600000X | Surgeon | D64593 | MD |
NPI | 1003923004 |
---|---|
Provider Name | Jennifer R Reed |
First Address | Norfolk, VA 23502-3931 |
Second Address | Norfolk, VA 23502-3931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 10/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
M61204 | CDS (01) | MD |