Individual
DR. OWEN DAVID REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
198 MASSACHUSETTS AVE STE 105, NORTH ANDOVER, MA 01845-4143
(978) 691-5690
(978) 691-5693
Mailing address
280 MERRIMACK ST STE 311, LAWRENCE, MA 01843-1779
(978) 691-5690
(978) 691-5693
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
74177
MA
207NS0135X
Procedural Dermatology Physician
74177
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3102769
—
MA
Enumeration date
10/19/2005
Last updated
12/03/2018
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