Individual
CHAD DAVID REAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO.1567
AL
363A00000X
Physician Assistant
PA-463
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
512-04537
BCBS OF AL
AL
Enumeration date
09/15/2006
Last updated
06/28/2019
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