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Individual
CHARLES HOWARD REISDORF
Active
Individual
CHARLES HOWARD REISDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704278150
MI
174H00000X
Health Educator
21310526
NULL
363L00000X
Nurse Practitioner
Primary
4704278150
MI
Other
Enumeration date
02/28/2011
Last updated
01/23/2026
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