Individual
DR. VIDA M. REKLAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(404) 851-6936
(404) 851-6024
Mailing address
51 HONOUR AVE NW, ATLANTA, GA 30305-1119
(770) 856-4147
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
034718
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000509605B
—
GA
05
—
000509605C
—
GA
01
—
004823
BCBS
GA
05
—
00509605B
—
GA
01
—
10044962
AMERIGROUP
GA
01
—
10480
KAISER
GA
01
—
245538
BCBS
GA
01
—
333414
WELLCARE
GA
Enumeration date
12/14/2005
Last updated
06/27/2014
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