Individual
MICHAEL ANTHONY REISIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2828 INTERNATIONAL CIR, SUITE 140, COLORADO SPRINGS, CO 80910-3127
(719) 632-5700
(719) 344-7821
Mailing address
340 PRINTERS PKWY, COLORADO SPRINGS, CO 80910-3190
(719) 632-5700
(719) 344-7837
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5776190-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061506129008
—
UT
05
—
90807782
—
CO
Enumeration date
07/12/2005
Last updated
09/23/2013
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