Individual
HARRY L REYNOLDS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7874
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
35-054245
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221055
UNISON
OH
01
—
000000503702
ANTHEM
—
05
—
2042177
—
OH
01
—
363949
WELLCARE
OH
01
—
5788605
AETNA
—
01
—
746002
BUCKEYE
OH
01
—
P00113985
RAILROAD MEDICARE
OH
Enumeration date
07/19/2006
Last updated
08/04/2010
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