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Individual

KEVIN JOHN REESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 452-1400
(910) 791-9626
Mailing address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 452-1400
(910) 791-9626

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9701125
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-28736
UNITED HEALTHCARE
NC
01
1073X
BCBS
NC
05
891073X
NC
01
930077045
RAILROAD MEDICARE
NC
01
930084667
RAILROAD MEDICARE
NC
01
B4556
MEDCOST
NC
05
Q0112D
SC
Enumeration date
06/14/2005
Last updated
10/12/2010
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