Individual
PATRICK SHAWN REYNOLDS
Active
Individual
PATRICK SHAWN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
96 01044
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1198R
BCBS
—
01
—
130025236
RR MEDICARE
—
05
—
2004310000
—
WV
01
—
28663
PARTNERS
—
05
—
7101431
—
VA
01
—
7240386
AETNA
—
01
—
87355
MEDCOST
—
05
—
891198R
—
NC
05
—
Q01048
—
SC
Enumeration date
12/20/2005
Last updated
11/12/2010
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