MEDICARE: CHRISTINA JEAN DELAND-REEVES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35-082754	OH
2	207Q00000X	Family Medicine Physician	3582754	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013912179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA JEAN DELAND-REEVES MD

Provider Business Mailing Address
First Line	:	1075 N WASHINGTON ST
Second Line	:
City	:	GREENFIELD
State	:	OH
Zip	:	45123-9780
Country	:	US
Telephone Number	:	937-981-9444
Fax Number	:	937-981-9448

Provider Business Practice Location Address
First Line	:	1075 N WASHINGTON ST
Second Line	:
City	:	GREENFIELD
State	:	OH
Zip	:	45123
Country	:	US
Telephone Number	:	937-981-9444
Fax Number	:	937-981-9448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	12/06/2022

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