Individual
DIANA REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 COURT ST STE 300, CHARLESTON, WV 25301-1654
(304) 342-8142
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16665
WV
208000000X
Pediatrics Physician
16665
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718053
WV BCBS
WV
01
—
1053521
WV DWC
WV
05
—
107302000
—
WV
Enumeration date
01/16/2006
Last updated
02/26/2013
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