Individual
SHANE GREGORY REIGHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1330 BOILING SPRINGS RD STE 2500, SPARTANBURG, SC 29303-4214
(864) 585-5433
(864) 591-4053
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
90834
SC
207RC0000X
Cardiovascular Disease Physician
Primary
90834
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
908344
—
SC
01
—
SCR2023365
MEDICARE PIN
SC
01
—
SCR2026084
MEDICARE PIN
SC
01
—
SCR2029225
MEDICARE PIN
SC
Enumeration date
04/12/2016
Last updated
06/10/2024
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