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Individual

MICHAEL JOSEPH REILLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-8186
Mailing address
PO BOX 418498, BOSTON, MA 02241-8498
(703) 558-1544

Taxonomy

Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
A102718
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0A1027180
CA
01
P00894821
RAILROAD MEDICARE
DC
Enumeration date
02/27/2008
Last updated
03/14/2012
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