Individual
DR. MICHAEL B REYNOLDS
Active
Individual
DR. MICHAEL B REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
046224
GA
207NS0135X
Procedural Dermatology Physician
046224
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007735230
AETNA
GA
05
—
000814767A
—
GA
01
—
070015990
RAILROAD MEDICARE
GA
01
—
1487604021
BCBS
GA
01
—
CH9982
RAILROAD MEDICARE
GA
Enumeration date
05/12/2006
Last updated
09/30/2013
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