Individual
DALE S REYNOLDS
Active
Individual
DALE S REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. PH.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
45473
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
569S2CE
BLUE CROSEE BLUE SHIELD
MN
05
—
80793200
—
MN
Enumeration date
03/09/2006
Last updated
05/06/2009
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