Individual
PATRICK DANIEL REIBOLD
Active
Individual
PATRICK DANIEL REIBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01042143
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091276
ANTHEM
IN
01
—
129480500
DEPT OF LABOR
IN
01
—
130014906
RR MEDICARE
IN
05
—
200014330A
—
IN
05
—
200476110I
—
IN
01
—
4455269
AETNA REFERRAL NUMBER
IN
Enumeration date
01/30/2006
Last updated
11/10/2022
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