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Individual

DR. SHAINA L REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
4190 E WOODMEN RD, SUITE 100, COLORADO SPRINGS, CO 80920-8075
(719) 632-4455
(719) 633-4613
Mailing address
4190 E WOODMEN RD, SUITE 100, COLORADO SPRINGS, CO 80920-8075
(719) 632-4455
(719) 633-4613

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036108703
IL
207Q00000X
Family Medicine Physician
Primary
52872
CO
207Q00000X
Family Medicine Physician
N1426
TX
208M00000X
Hospitalist Physician
N1426
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036108703
IL
01
P00030453
MEDICARE RAILROAD
IL
Enumeration date
04/26/2006
Last updated
08/15/2013
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