Individual
GEORGE M REYNOLDS
Active
Individual
GEORGE M REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
10138
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012187
—
MS
01
—
753068151
MHP
—
01
—
753068151016
TRICARE
—
Enumeration date
07/19/2006
Last updated
12/13/2012
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