Individual
CRAIG A. REICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETOIT, MI 48202
(313) 916-2600
Mailing address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETOIT, MI 48202
(313) 916-2600
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
4301059439
MI
208C00000X
Colon & Rectal Surgery Physician
Primary
4301059439
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
280H264470
BLUE CROSS-BLUE CROSS
—
05
—
454306810
—
MI
01
—
CR059439
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
10/10/2006
Last updated
07/17/2018
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