Organization
PAUL D. REICHERTER, MD, PC
Active
Other names
Advanced Skin Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL D REICHERTER MD (PRESIDENT)
(541) 672-7546
Entity
Organization
Contact information
Practice address
1813 W HARVARD AVE STE 310, ROSEBURG, OR 97471-2756
(541) 672-7546
(541) 957-8446
Mailing address
1813 W HARVARD AVE STE 310, ROSEBURG, OR 97471-2756
(541) 672-7546
(541) 957-8446
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD23536
OR
207ND0101X
MOHS-Micrographic Surgery Physician
MD23536
OR
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
Primary
MD23536
OR
207NP0225X
Pediatric Dermatology Physician
MD23536
OR
207NS0135X
Procedural Dermatology Physician
MD23536
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
286785
OHP
OR
05
—
286785
—
OR
01
—
38D1028702
CLIA
OR
01
—
838392000
BCBS
OR
01
—
DC5977
MEDICARE RAILROAD
—
Enumeration date
07/11/2007
Last updated
02/15/2016
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