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Individual

RICHARD REIFENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1522 W MORRIS ST, INDIANAPOLIS, IN 46221-1629
(317) 488-2020
(317) 488-2031
Mailing address
3401 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 788-9769
(317) 781-4868

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01047123A
IN
208000000X
Pediatrics Physician
01047123A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200261630A
IN
Enumeration date
10/06/2005
Last updated
07/19/2011
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