Individual
JAMES R REIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1080 UNIVERSITY BLVD, RICHMOND, IN 47374-1256
(765) 914-0946
(765) 939-0138
Mailing address
1080 UNIVERSITY BLVD, RICHMOND, IN 47374-1256
(765) 914-0946
(765) 939-0138
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01058750A
IN
207R00000X
Internal Medicine Physician
2012-00404
NC
207R00000X
Internal Medicine Physician
24137
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821100504
—
SC
05
—
200457950
—
IN
05
—
5920310
—
NC
01
—
AA2638
MEDICARE PTAN
SC
01
—
NC7012A
MEDICARE PTAN
NC
Enumeration date
08/31/2006
Last updated
01/23/2017
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