Individual
DR. WARREN K REISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
921 N LAKE SHORE DR, CULVER, IN 46511-1207
(574) 842-3327
(574) 842-4330
Mailing address
PO BOX 6309, SOUTH BEND, IN 46660-6309
(574) 335-8700
(574) 335-0760
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01026349A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083972
BCBS
IN
05
—
100173440
—
IN
01
—
15D0356500
CLIA
IN
01
—
207Q000000X
TAXONOMY
IN
Enumeration date
05/16/2006
Last updated
05/08/2015
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