Individual
NICHOLAS JORDAN REAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(908) 448-7842
Mailing address
202 PEGGYS TRCE, SNEADS FERRY, NC 28460-6875
(908) 448-7842
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101265140
VA
207L00000X
Anesthesiology Physician
2021-03054
NC
Other
Enumeration date
03/14/2017
Last updated
05/29/2024
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