Individual
MATTHEW J RESCHLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 RIVERSIDE PKWY STE 100, LAWRENCEVILLE, GA 30043-5926
(470) 273-7233
Mailing address
268 RUMSON RD NE, ATLANTA, GA 30305-3114
(404) 323-4260
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
053393
GA
207ND0900X
Dermatopathology Physician
053393
GA
207NS0135X
Procedural Dermatology Physician
053393
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
703213
BCBS
GA
05
—
749377509A
—
GA
05
—
749377509C
—
GA
05
—
749377509D
—
GA
05
—
749377509E
—
GA
01
—
P00119685
RR MEDICARE
GA
Enumeration date
08/22/2005
Last updated
03/27/2023
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