Individual
DR. EDWIN H. REISFELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
15720 JOHN J DELANEY DR, SUITE 300, CHARLOTTE, NC 28277-3430
(704) 927-5881
(704) 944-3201
Mailing address
52511 WINCHESTER STREET, FORT MILL, SC 29707
(704) 927-5881
(704) 944-3201
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3748
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2826004
MEDICARE PTAN
NC
01
—
2826004A
MEDICARE INDIVIDUAL PTAN
NC
Enumeration date
10/18/2005
Last updated
08/22/2011
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