Individual
DR. ROBERT EUGENE REARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5001
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000123581
ANTHEM BLUE SHIELD
OH
05
—
0233198
—
OH
01
—
1535088
UMWA
OH
01
—
352766
STAYWELL HEALTH/WELLCARE
OH
Enumeration date
12/22/2005
Last updated
12/03/2007
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