Individual
MARY MARTHA REAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
613 23RD ST STE 350, ASHLAND, KY 41101-2879
(606) 408-4600
(606) 408-4605
Mailing address
PO BOX 2057, ASHLAND, KY 41105-2057
(606) 329-0799
(606) 329-0947
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20802
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0545093
—
OH
01
—
5484
MEDICARE GROUP NUMBER
KY
05
—
64208028
—
KY
Enumeration date
08/23/2005
Last updated
01/10/2023
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