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Individual
SCOT BRADLEY RHEINECKER
Active
Individual
SCOT BRADLEY RHEINECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102270
NC
363AM0700X
Medical Physician Assistant
102270
NC
363AS0400X
Surgical Physician Assistant
102270
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5842575
AETNA
NC
01
—
D5862
MEDCOST
NC
01
—
P00168136
RAILROAD MEDICARE
NC
Enumeration date
01/17/2006
Last updated
05/02/2011
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