Individual
REINA HISADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
621 S MAIN ST STE 200, REIDSVILLE, NC 27320-5034
(336) 349-4454
Mailing address
621 S MAIN ST STE 200, REIDSVILLE, NC 27320-5034
(336) 349-4454
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1457615585
NC
390200000X
Student in an Organized Health Care Education/Training Program
182996
NC
Other
Enumeration date
07/03/2012
Last updated
10/24/2017
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