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Individual

DR. DAVID M REARDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1620 MEDICAL LN, SUITE 100, FORT MYERS, FL 33907-1143
(239) 275-1164
(239) 275-5212
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(214) 932-8029
(610) 271-4245

Taxonomy

Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
ME50460
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME50460
FL
207ZP0104X
Chemical Pathology Physician
ME50460
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
374108700
FL
Enumeration date
01/11/2006
Last updated
05/07/2015
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